Martich, G Daniel; Waldmann, Carl S; Imhoff, Michael
Health care information systems have the potential to enable better care of patients in much the same manner as the widespread use of the automobile and telephone did in the early 20th century. The car and phone were rapidly accepted and embraced throughout the world when these breakthroughs occurred. However, the automation of health care with use of computerized information systems has not been as widely accepted and implemented as computer technology use in all other sectors of the global economy. In this article, the authors examine the need, risks, and rewards of clinical informatics in health care as well as its specific relationship to critical care medicine.
John R Gilbertson
Full Text Available Background: In 2007, our healthcare system established a clinical fellowship program in pathology informatics. In 2011, the program benchmarked its structure and operations against a 2009 white paper "Program requirements for fellowship education in the subspecialty of clinical informatics," endorsed by the Board of the American Medical Informatics Association (AMIA that described a proposal for a general clinical informatics fellowship program. Methods: A group of program faculty members and fellows compared each of the proposed requirements in the white paper with the fellowship program′s written charter and operations. The majority of white paper proposals aligned closely with the rules and activities in our program and comparison was straightforward. In some proposals, however, differences in terminology, approach, and philosophy made comparison less direct, and in those cases, the thinking of the group was recorded. After the initial evaluation, the remainder of the faculty reviewed the results and any disagreements were resolved. Results: The most important finding of the study was how closely the white paper proposals for a general clinical informatics fellowship program aligned with the reality of our existing pathology informatics fellowship. The program charter and operations of the program were judged to be concordant with the great majority of specific white paper proposals. However, there were some areas of discrepancy and the reasons for the discrepancies are discussed in the manuscript. Conclusions: After the comparison, we conclude that the existing pathology informatics fellowship could easily meet all substantive proposals put forth in the 2009 clinical informatics program requirements white paper. There was also agreement on a number of philosophical issues, such as the advantages of multiple fellows, the need for core knowledge and skill sets, and the need to maintain clinical skills during informatics training. However
Valenta, Annette L.; Wigger, Ulrike
Objective: To introduce the Q-methodology research technique to the field of health informatics. Q-methodology—the systematic study of subjectivity—was used to identify and categorize the opinions of primary care physicians and medical students that contributed to our understanding of their reasons for acceptance of and/or resistance to adapting information technologies in the health care workplace.
Karthik, Kavitha; Munuswamy, Suresh
This proposed study will be conducted in Telangana and Tamil Nadu states in India. Mapping of Health care Professionals by a web-based Delphi technique followed by Focus Group Discussion and Evaluation of Knowledge, Attitude, Practise and Adoption among Health Care Professionals for informatics/computerised technology systems by using structured questionnaire for knowledge and practice and for Attitudes toward Computers in Healthcare (P.A.T.C.H.) Scale will be used to collect the data. This study results will create evidence on present and relevant informatics/computerized technology systems needs and help the research team to develop informatics competencies list and design an online or offline skill up gradation programs for health professionals in India according to their diverse roles in the health care system. The researcher team believes these results will have National relevance to the current focus areas of Government of India and to strengthen the Health Informatics Program offered in IIPH, Hyderabad.
Rigby, Michael; Hill, Penny; Koch, Sabine; Kärki, Jarmo
To the individual, social care can be an essential part of maintaining health, as is reflected by the WHO definition of health as being one of wellbeing. However, health informatics currently narrowly restricts itself to health organizations' activities. Digital records in social care are increasing, raising the need to recognize the area of social care informatics. This new domain needs support and nurture, whilst the delivery of social and related care needs to be harmonized with healthcare delivery. In turn, this raises important new issues as to how to best support the citizen, especially when they are dependent, including issues of information sharing, service co-ordination, sharing of meaning and objectives, and of respect for autonomy.
Tremblay, Monica Chiarini; Deckard, Gloria J; Klein, Richard
Health care organizations must develop integrated health information systems to respond to the numerous government mandates driving the movement toward reimbursement models emphasizing value-based and accountable care. Success in this transition requires integrated data analytics, supported by the combination of health informatics, interoperability, business process design, and advanced decision support tools. This case study presents the development of a master's level cross- and multidisciplinary informatics program offered through a business school. The program provides students from diverse backgrounds with the knowledge, leadership, and practical application skills of health informatics, information systems, and data analytics that bridge the interests of clinical and nonclinical professionals. This case presents the actions taken and challenges encountered in navigating intra-university politics, specifying curriculum, recruiting the requisite interdisciplinary faculty, innovating the educational format, managing students with diverse educational and professional backgrounds, and balancing multiple accreditation agencies.
Hercigonja-Szekeres, Mira; Simić, Diana; Božikov, Jadranka; Vondra, Petra
Paper presents an overview of the EU funded Project of Curriculum Development for Interdisciplinary Postgraduate Specialist Study in Medical Informatics named MEDINFO to be introduced in Croatia. The target group for the program is formed by professionals in any of the areas of medicine, IT professionals working on applications of IT for health and researchers and teachers in medical informatics. In addition to Croatian students, the program will also provide opportunity for enrolling students from a wider region of Southeast Europe. Project partners are two faculties of the University of Zagreb - Faculty of Organization and Informatics from Varaždin and School of Medicine, Andrija Štampar School of Public Health from Zagreb with the Croatian Society for Medical Informatics, Croatian Chamber of Economy, and Ericsson Nikola Tesla Company as associates.
Full Text Available in informatization programs are approached: criteria of efficiency, general problem, aggregate problem in continuous form, general problem in discrete form and solving of problems. As criterion of informatization projects' economic efficiency, the total profit maximization due to investments is used. In preliminary calculations, the opportunity of considering continuous dependences of profit on the volume of investments by domain activities is grounded. Eleven classes of such dependences are investigated and analytical solutions and algorithms for solving formulated problems are described.
Over the past decade, there has been a conversion to electronic health records (EHRs) in an effort to improve patient care, access, and efficiency. The goal, which has been supported by federal initiatives, is to meaningfully use informatics to improve the safety and quality of patient care as a major force in improving healthcare. How nurses…
Simpao, Allan F; Ahumada, Luis M; Gálvez, Jorge A; Rehman, Mohamed A
Federal investment in health information technology has incentivized the adoption of electronic health record systems by physicians and health care organizations; the result has been a massive rise in the collection of patient data in electronic form (i.e. "Big Data"). Health care systems have leveraged Big Data for quality and performance improvements using analytics-the systematic use of data combined with quantitative as well as qualitative analysis to make decisions. Analytics have been utilized in various aspects of health care including predictive risk assessment, clinical decision support, home health monitoring, finance, and resource allocation. Visual analytics is one example of an analytics technique with an array of health care and research applications that are well described in the literature. The proliferation of Big Data and analytics in health care has spawned a growing demand for clinical informatics professionals who can bridge the gap between the medical and information sciences.
Full Text Available This paper investigates the ability of a group of Primary Care professionals to acquire appropriate document retrieval skills, so that they can apply evidence based health care techniques to their various Primary Care roles. The participants, most of whom had little prior experience of the Internet, were enrolled on a two-year part-time Postgraduate Diploma / MSc in Primary Care. As part of the course, they took a compulsory 12-week module in Medical Informatics. A specific task was set: to find appropriate information on Meningococcal Meningitis and Public Health, by using National Library of Medicine's PUBMED bibliographic retrieval system and other unspecified Internet sources. A supplementary piece of coursework required the group to become information providers by providing tutorials on the world wide web. Analysis of the reports showed that the participants were able to learn and use the information tools successfully and that appropriate skills can be transferred in a short time. Overall nine were positive as to the benefits of the evidence-based approach contributing to local health care, with nine expressing mixed views and two having more negative opinions.
Ontologies are now widely used in the biomedical domain. However, it is difficult to manipulate ontologies in a computer program and, consequently, it is not easy to integrate ontologies with databases or websites. Two main approaches have been proposed for accessing ontologies in a computer program: traditional API (Application Programming Interface) and ontology-oriented programming, either static or dynamic. In this paper, we will review these approaches and discuss their appropriateness for biomedical ontologies. We will also present an experience feedback about the integration of an ontology in a computer software during the VIIIP research project. Finally, we will present OwlReady, the solution we developed.
Campbell, Jayne M; Roderer, Nancy K
Preparing librarians to meet the information challenges faced in the current and future health care environments is critical. At Johns Hopkins University, three NLM-funded fellowship programs provide opportunities for librarians to utilize the rich environments of the Welch Medical Library and the Division of Health Sciences Informatics in support of life-long learning.
Lehmann, C U; Longhurst, C A; Hersh, W; Mohan, V; Levy, B P; Embi, P J; Finnell, J T; Turner, A M; Martin, R; Williamson, J; Munger, B
In the US, the new subspecialty of Clinical Informatics focuses on systems-level improvements in care delivery through the use of health information technology (HIT), data analytics, clinical decision support, data visualization and related tools. Clinical informatics is one of the first subspecialties in medicine open to physicians trained in any primary specialty. Clinical Informatics benefits patients and payers such as Medicare and Medicaid through its potential to reduce errors, increase safety, reduce costs, and improve care coordination and efficiency. Even though Clinical Informatics benefits patients and payers, because GME funding from the Centers for Medicare and Medicaid Services (CMS) has not grown at the same rate as training programs, the majority of the cost of training new Clinical Informaticians is currently paid by academic health science centers, which is unsustainable. To maintain the value of HIT investments by the government and health care organizations, we must train sufficient leaders in Clinical Informatics. In the best interest of patients, payers, and the US society, it is therefore critical to find viable financial models for Clinical Informatics fellowship programs. To support the development of adequate training programs in Clinical Informatics, we request that the Centers for Medicare and Medicaid Services (CMS) issue clarifying guidance that would allow accredited ACGME institutions to bill for clinical services delivered by fellows at the fellowship program site within their primary specialty.
Kullar, Ravina; Goff, Debra A
The successful integration of technology in antimicrobial stewardship programs has made it possible for clinicians to function more efficiently. With government endorsement of electronic health records (EHRs), EHRs and clinical decision support systems (CDSSs) are being used as decision support tools to aid clinicians in efforts to improve antibiotic use. Likewise, medical applications (apps) have provided educational tools easily accessible to clinicians through their mobile devices. In this article, the impact that informatics and technology have had on promoting antibiotic stewardship is described, focusing on EHRs and CDSSs, apps, electronic resources, and social media.
Fulton, Cathy R; Meek, Julie A; Walker, Patricia Hinton
Nursing informatics/health information technology are key components of graduate nursing education and an accreditation requirement, yet little is known about the extent to which doctor of nursing practice (DNP) curricula include these content domains. The purpose of this descriptive study was to elicit perceptions of DNP program directors relative to (a) whether and how the American Association of Colleges of Nursing's (AACN's) Essential IV standard has been met in their DNP programs; (b) whether the Technology Informatics Guiding Educational Reform Initiative Foundation's Phase II competencies have been integrated in their programs; and (c) the faculty and organizational characteristics associated with the adoption of the AACN's Essential IV. In 2011, an electronic survey was sent to all 138 DNP program directors identified on the AACN Web site with an 81.2% response rate. Findings include variation in whether and how programs have integrated informatics/health information technology content, a lack of informatics-certified and/or master's-prepared faculty, and a perceived lack of faculty awareness of informatics curricular guidelines. DNP program director and dean awareness and support of faculty informatics education, use of informatics competency guidelines, and national policy and stimulus funding support are recommended to promote curricular inclusion and the engagement of nurses in strong informatics practices.
Over the last decade there is an intensive discussion within the Information Systems (IS) and Informatics community about the characteristics and identity of the discipline. Simultaneously with the discussion, there is an ongoing debate on essential skills and capabilities of IS and Business Informatics graduates as well as the profile of IS…
Clifford Gari D
Abstract This article is an invited review of the third edition of "Biomedical Informatics; Computer Applications in Health Care and Biomedicine", one of thirty-six volumes in Springer's 'Health Informatics Series', edited by E. Shortliffe and J. Cimino. This book spans most of the current methods and issues in health informatics, ranging through subjects as varied as data acquisition and storage, standards, natural language processing, imaging, electronic health records, decision support, te...
Skiba, Diane J
The use of health information technologies has evolved over the last 50 years. These technologies have moved from the automation of data and data processing to connected care tools that are part of a health care ecosystem that provides the best care at the point of care. To correspondence with the evolution of technologies and their disruptions within the health care delivery system, there is a need to re-examine the necessary competencies of health care professionals.
Bloomrosen, Meryl; Detmer, Don E
There is an increased level of activity in the biomedical and health informatics world (e-prescribing, electronic health records, personal health records) that, in the near future, will yield a wealth of available data that we can exploit meaningfully to strengthen knowledge building and evidence creation, and ultimately improve clinical and preventive care. The American Medical Informatics Association (AMIA) 2008 Health Policy Conference was convened to focus and propel discussions about informatics-enabled evidence-based care, clinical research, and knowledge management. Conference participants explored the potential of informatics tools and technologies to improve the evidence base on which providers and patients can draw to diagnose and treat health problems. The paper presents a model of an evidence continuum that is dynamic, collaborative, and powered by health informatics technologies. The conference's findings are described, and recommendations on terminology harmonization, facilitation of the evidence continuum in a "wired" world, development and dissemination of clinical practice guidelines and other knowledge support strategies, and the role of diverse stakeholders in the generation and adoption of evidence are presented.
Travis, L; Flatley Brennan, P
Health care is increasingly driven by information, and consequently, patient care will demand effective management of information. The report of the Priority Expert Panel E: Nursing Informatics and Enhancing Clinical Care Through Nursing Informatics challenges faculty to produce baccalaureate graduates who use information technologies to improve the patient care process and change health care. The challenge is to construct an evolving nursing informatics curriculum to provide nursing professionals with the foundation for affecting health care delivery. This article discusses the design, implementation, and evaluation of an innovative nursing informatics curriculum incorporated into a baccalaureate nursing program. The basic components of the curriculum framework are information, technology, and clinical care process. The presented integrated curriculum is effective in familiarizing students with informatics and encouraging them to think critically about using informatics in practice. The two groups of students who completed the four-course sequence will be discussed.
Conclusions A clinical informatics system, used to deliver proactive, co-ordinated care to a population of patients with diabetes mellitus, can improve process and also quality outcome measures. Larger studies are needed to confirm these early findings.
Jones, Kamas; Kapsandoy, Seraphine; Macintosh, Christopher; Wyckoff, Anastasis
In order to facilitate the incorporation of Informatics competencies into nursing curricula, this group analyzed the course content of three BSN level nursing classes and correlated appropriate competencies to the course content. The two main areas of focus were competencies already used and competencies easily incorporated.
Li, Man; Pickering, Brian W; Smith, Vernon D; Hadzikadic, Mirsad; Gajic, Ognjen; Herasevich, Vitaly
Medical Informatics has become an important tool in modern health care practice and research. In the present article we outline the challenges and opportunities associated with the implementation of electronic medical records (EMR) in complex environments such as intensive care units (ICU). We share our initial experience in the design, maintenance and application of a customized critical care, Microsoft SQL based, research warehouse, ICU DataMart. ICU DataMart integrates clinical and administrative data from heterogeneous sources within the EMR to support research and practice improvement in the ICUs. Examples of intelligent alarms -- "sniffers", administrative reports, decision support and clinical research applications are presented.
Darvish, Asieh; Bahramnezhad, Fatemeh; Keyhanian, Sara; Navidhamidi, Mojdeh
In today's dynamic health systems, technology plays an important role in education and nursing work. So it seems necessary to study the role of nurses and highlight the need for appropriate information technology educational programs to integrate with the ever-increasing pace of technology. A review accompanied by an extensive literature search in databases and a library search focused on the keywords were used. The criteria used for selecting studies primarily focused on nursing informatics and the importance of expertise in the effective use of information technology in all aspects of the nursing profession. In a critical assessment of emerging technologies, the key elements of nursing informatics implementation were considered as healthcare promotion, advanced systems, internet and network. In view of the nature and the development of the information age, it is required to receive necessary IT training for all categories of nurses. Due to the fast development of technology, in order to effectively take advantage of information technology in nursing outcome and quality of health care and to empower nurses; educational arrangement is recommended to set short-term and long-term specialized courses focusing on four target groups: studying, working, graduate, senior undergraduate, and graduate doctoral. The result of this study is expected to assist educational providers with program development.
Abdullah Talha Kabakuş
Full Text Available There is no industry that does not benefit from the advantages of information technology (IT. Health care industry is no different from them. IT solutions are used to minimize the human resource required for labor-intensive or time consuming tasks by automating them, benefit from the intelligent software solutions that not just store the data in electronic format but also ease the decision making process, accelerate the business processes by providing services simultaneously, and provide maintainable and consistent services. Despite all of these advantages, health care industry spends only 2% of its revenues on technology, which is very limited when it is compared to other industries that spend around 10%.
Clifford Gari D
Full Text Available Abstract This article is an invited review of the third edition of "Biomedical Informatics; Computer Applications in Health Care and Biomedicine", one of thirty-six volumes in Springer's 'Health Informatics Series', edited by E. Shortliffe and J. Cimino. This book spans most of the current methods and issues in health informatics, ranging through subjects as varied as data acquisition and storage, standards, natural language processing, imaging, electronic health records, decision support, teaching methods and ethics. The book is aimed at 'healthcare professionals', and is certainly appropriate for the non-technical informatics user. However, this book is also excellent background reading for the technical engineer who may be interested in the possible problems that confront the users in this field.
Srinivasan Sridhar, Divya
Recent healthcare reform and its provisions have pushed health information technology (HIT) into the forefront. Higher life expectancies, fewer medical errors, lower costs, and improved transparency are all possible through HIT. Taking an integrated approach, Impact of Healthcare Informatics on Quality of Patient Care and Health Services examines the various types of organizations, including nonprofit hospitals, for-profit hospitals, community health centers, and government hospitals. By doing so, it provides you with a comparative perspective of how different organizations adapt and use the t
Vito, D; Diltz, M; Porter, M; White, P; Luberti, A
As the bar to actively participate in one's own health is consistently lowered through technology, patients are helping to evolve traditional workflows to make data more accessible at the point of care. This growing trend of patient engagement and personalized medicine was the focus of the 2013 Mid-Atlantic Healthcare Informatics Symposium in Philadelphia, PA on April 26, 2013. The conference, presented annually by the Center for Bio-medical Informatics (CBMi) at The Children's Hospital of Philadelphia, featured plenary sessions, panel discussions, and paper presentations on a range of topics, including patient engagement and personalized medicine; using data and analytics to optimize patient care; nursing informatics; and the future of biomedical informatics.
Choi, In Young; Kim, Tae-Min; Kim, Myung Shin; Mun, Seong K; Chung, Yeun-Jun
The advances in electronic medical records (EMRs) and bioinformatics (BI) represent two significant trends in healthcare. The widespread adoption of EMR systems and the completion of the Human Genome Project developed the technologies for data acquisition, analysis, and visualization in two different domains. The massive amount of data from both clinical and biology domains is expected to provide personalized, preventive, and predictive healthcare services in the near future. The integrated use of EMR and BI data needs to consider four key informatics areas: data modeling, analytics, standardization, and privacy. Bioclinical data warehouses integrating heterogeneous patient-related clinical or omics data should be considered. The representative standardization effort by the Clinical Bioinformatics Ontology (CBO) aims to provide uniquely identified concepts to include molecular pathology terminologies. Since individual genome data are easily used to predict current and future health status, different safeguards to ensure confidentiality should be considered. In this paper, we focused on the informatics aspects of integrating the EMR community and BI community by identifying opportunities, challenges, and approaches to provide the best possible care service for our patients and the population.
Djorgovski, S G; Crichton, D; Chaudhry, B
Big Data are revolutionizing nearly every aspect of the modern society. One area where this can have a profound positive societal impact is the field of Health Care Informatics (HCI), which faces many challenges. The key idea behind this study is: can we use some of the experience and technical and methodological solutions from the fields that have successfully adapted to the Big Data era, namely astronomy and space science, to help accelerate the progress of HCI? We illustrate this with examples from the Virtual Observatory framework, and the NCI EDRN project. An effective sharing and reuse of tools, methods, and experiences from different fields can save a lot of effort, time, and expense. HCI can thus benefit from the proven solutions to big data challenges from other domains.
Moehr, J R; Berenji, G R; Green, C J; Kagolovsky, Y
Teaching the skills and knowledge required in health informatics  is a challenge because the skill of applying knowledge in real life requires practice. We relate the experience with introducing a practice component to a course in "Health Care Quality Improvement". Working health care professionals were invited to bring an actual quality problem from their place of work and to work alongside students in running the problem through a quality improvement project lifecycle. Multiple technological and process oriented teaching innovations were employed including project sessions in observation rooms, video recording of these sessions, generation of demonstration examples and distance education components. Both students and their collaborators from the work place developed proficiency in applying quality improvement methods as well as in experiencing the realities of group processes, information gaps and organizational constraints. The principles used to achieve high involvement of the whole class, the employed resources and technical support are described. The resulting academic and practical achievements are discussed in relation to the alternative instructional modalities, and with respect to didactic implications for similar endeavors and beyond to other fields such as systems engineering.
Kushniruk, Andre; Borycki, Elizabeth; Armstrong, Brian; Kuo, Mu-Hsing
The paper describes the authors' work in the area of health informatics (HI) education involving emerging health information technologies. A range of information technologies promise to modernize health care. Foremost among these are electronic health records (EHRs), which are expected to significantly improve and streamline health care practice. Major national and international efforts are currently underway to increase EHR adoption. However, there have been numerous issues affecting the widespread use of such information technology, ranging from a complex array of technical problems to social issues. This paper describes work in the integration of information technologies directly into the education and training of HI students at both the undergraduate and graduate level. This has included work in (a) the development of Web-based computer tools and platforms to allow students to have hands-on access to the latest technologies and (b) development of interdisciplinary educational models that can be used to guide integrating information technologies into HI education. The paper describes approaches that allow for remote hands-on access by HI students to a range of EHRs and related technology. To date, this work has been applied in HI education in a variety of ways. Several approaches for integration of this essential technology into HI education and training are discussed, along with future directions for the integration of EHR technology into improving and informing the education of future health and HI professionals.
Desjardins, Karen S; Cook, Sarah Sheets; Jenkins, Melinda; Bakken, Suzanne
Effective and appropriate use of information and communication technologies is an essential competency for all health care professionals. The purpose of this paper is to describe the effect of an evolving informatics for evidence-based practice (IEBP) curriculum on nursing informatics competencies in three student cohorts in the combined BS/MS program for non-nurses at the Columbia University School of Nursing. A repeated-measures, non-equivalent comparison group design was used to determine differences in self-rated informatics competencies pre- and post-IEBP and between cohorts at the end of the BS year of the combined BS/MS program. The types of Computer Skill competencies on which the students rated themselves as competent (> or =3) on admission were generic in nature and reflective of basic computer literacy. Informatics competencies increased significantly from admission to BS graduation in all areas for the class of 2002 and in all, but three areas, for the class of 2003. None of the three cohorts achieved competence in Computer Skills: Education despite curricular revisions. There were no significant differences between classes at the end of the BS year. Innovative educational approaches, such as the one described in this paper demonstrate promise as a method to achieve informatics competence. It is essential to integrate routine measurement of informatics competency into the curriculum so that approaches can be refined as needed to ensure informatics competent graduates.
Carlos Javier Carvajal Montealegre
Full Text Available This paper describes the data mining process to obtain classification rules over an information security incident data collection, explaining in detail the use of genetic programming as a mean to model the incidents behavior and representing such rules as decision trees. The described mining process includes several tasks, such as the GP (Genetic Programming approach evaluation, the individual's representation and the algorithm parameters tuning to upgrade the performance. The paper concludes with the result analysis and the description of the rules obtained, suggesting measures to avoid the occurrence of new informatics attacks. This paper is a part of the thesis work degree: Information Security Incident Analytics by Data Mining for Behavioral Modeling and Pattern Recognition (Carvajal, 2012.
Jaspers, Monique W M; Hasman, Arie
The University of Amsterdam redesigned its former 4 years Medical Informatics university program into a Dutch 3 years BSc program and a 2 years English MSc program. The new MSc program is aimed at (international) baccalaureates in medical informatics, computer science, medicine, health sciences, and biology. Besides, health care professionals or professionals with a background in computer science may enter the program. We present our new MSc program shortly.
This paper examines the importance of data, information, and informatics to public health practice. Forty public health academicians from 40 schools and graduate programs of public health were interviewed. All agreed that informatics was important to public health practice. A qualitative analysis of their comments revealed their beliefs on the importance of informatics skills and knowledge to the practice of public health. The resulting comment groups varied from "some skills are more important than others" to "need all the skills." Eight "importance" comment groups were formed: 1) skills for all professionals; 2) some skills more than others; 3) yes, they need all the skills; 4) skills to become better practitioners; 5) usefulness to practitioners; 6) communication with public; 7) they're [the public] are depending on us; and 8) the future.
García, Patricia J.; Egoavil, Miguel S.; Blas, Magaly M.; Alvarado-Vásquez, Eduardo; Curioso, Walter H.; Zimic, Mirko; Castagnetto, Jesus M.; Lescano, Andrés G.; Lopez, Diego M.; Cárcamo, Cesar P.
Training in Biomedical Informatics is essential to meet the challenges of a globalized world. However, the development of postgraduate training and research programs in this area are scarce in Latin America. Through QUIPU: Andean Center for Training and research in Iformatics for Global Health, has developed the first Certificate and Master’s Program on Biomedical Informatics in the Andean Region. The aim of this article is to describe the experience of the program. To date, 51 students from Peru, Chile, Ecuador, Colombia and Venezuela have participated; they come from health ministries, hospitals, universities, research centers, professional associations and private companies. Seventeen courses were offered with the participation of faculty from Argentina, Chile, Colombia, USA, Mexico and Peru. This program is already institutionalized at the School of Public Health and Administration from the Universidad Peruana Cayetano Heredia. PMID:26338399
García, Patricia J; Egoavil, Miguel S; Blas, Magaly M; Alvarado-Vásquez, Eduardo; Curioso, Walter H; Zimic, Mirko; Castagnetto, Jesus M; Lescano, Andrés G; Lopez, Diego M; Cárcamo, Cesar P
Training in Biomedical Informatics is essential to meet the challenges of a globalized world. However, the development of postgraduate training and research programs in this area are scarce in Latin America. Through QUIPU: Andean Center for Training and research in Iformatics for Global Health, has developed the first Certificate and Masters Program on Biomedical Informatics in the Andean Region. The aim of this article is to describe the experience of the program. To date, 51 students from Peru, Chile, Ecuador, Colombia and Venezuela have participated; they come from health ministries, hospitals, universities, research centers, professional associations and private companies. Seventeen courses were offered with the participation of faculty from Argentina, Chile, Colombia, USA, Mexico and Peru. This program is already institutionalized at the School of Public Health and Administration from the Universidad Peruana Cayetano Heredia.
Johnson, Layne M; Ames, Trevor R; Jacko, Julie A; Watson, Linda A
Information and data management are essential to support the collaborative and interdisciplinary pursuits of an academic veterinary medicine enterprise, ranging from research conducted by individual investigators, education processes, clinical care, and outreach to administration and management. Informatics is an academic discipline that focuses on the creation, management, storage, retrieval, and use of information and data and how technology can be applied to improve access to and use of these resources. In this article, we discuss the challenges in integrating informatics across a large academic enterprise from a veterinary medicine point of view. As a case study, we describe an example program of informatics at the University of Minnesota designed to support interdisciplinary collaboration.
Leven, F J
Requirements and approaches of Software Engineering education in the field of Medical Informatics are described with respect to the impact of (1) experiences characterizing the "software misery", (2) status and tendencies in software methodology, and (3) educational status and needs in computer science education influenced by the controversy "theoretical versus practical education". Special attention is directed toward the growing importance of analysis, design methods, and techniques in the professional spectrum of Medical Informatics, the relevance of general principles of systems engineering in health care, the potential of non-procedural programming paradigms, and the intersection of Artificial Intelligence and education. Realizations of and experiences with programs in the field of Software Engineering are reported with respect to special requirements in Medical Informatics.
Rhoads, Daniel D; Sintchenko, Vitali; Rauch, Carol A; Pantanowitz, Liron
The clinical microbiology laboratory has responsibilities ranging from characterizing the causative agent in a patient's infection to helping detect global disease outbreaks. All of these processes are increasingly becoming partnered more intimately with informatics. Effective application of informatics tools can increase the accuracy, timeliness, and completeness of microbiology testing while decreasing the laboratory workload, which can lead to optimized laboratory workflow and decreased costs. Informatics is poised to be increasingly relevant in clinical microbiology, with the advent of total laboratory automation, complex instrument interfaces, electronic health records, clinical decision support tools, and the clinical implementation of microbial genome sequencing. This review discusses the diverse informatics aspects that are relevant to the clinical microbiology laboratory, including the following: the microbiology laboratory information system, decision support tools, expert systems, instrument interfaces, total laboratory automation, telemicrobiology, automated image analysis, nucleic acid sequence databases, electronic reporting of infectious agents to public health agencies, and disease outbreak surveillance. The breadth and utility of informatics tools used in clinical microbiology have made them indispensable to contemporary clinical and laboratory practice. Continued advances in technology and development of these informatics tools will further improve patient and public health care in the future.
Musso, Carlos; Aguilera, Jerónimo; Otero, Carlos; Vilas, Manuel; Luna, Daniel; de Quirós, Fernán González Bernaldo
Biomedical informatics in Health (BIH) is the discipline in charge of capturing, handling and using information in health and biomedicine in order to improve the processes involved with assistance and management. Informatic nephrology has appeared as a product of the combination between conventional nephrology with BIH and its development has been considerable in the assistance as well as in the academic field. Regarding the former, there is increasing evidence that informatics technology can make nephrological assistance be better in quality (effective, accessible, safe and satisfying), improve patient's adherence, optimize patient's and practitioner's time, improve physical space and achieve health cost reduction. Among its main elements, we find electronic medical and personal health records, clinical decision support system, tele-nephrology, and recording and monitoring devices. Additionally, regarding the academic field, informatics and Internet contribute to education and research in the nephrological field. In conclusion, informatics nephrology represents a new field which will influence the future of nephrology.
Medical informatics, as scientific discipline, has to do with all aspects of understanding and promoting the effective organization, analysis, management, and use of information in health care. While the field of Medical informatics shares the general scope of these interests with some other health care specialities and disciplines, Medical (Health) informatics has developed its own areas of emphasis and approaches that have set it apart from other disciplines and specialities. For the last fifties of 20th century and some more years of 21st century, Medical informatics had the five time periods of characteristic development. In this paper author shortly described main scientific innovations and inventors who created development of Medical informatics.
Abdrbo, Amany Ahmed
With implementation of information technology in healthcare settings to promote safety and evidence-based nursing care, a growing emphasis on the importance of nursing informatics competencies has emerged. This study assessed the relationship between nursing informatics and patient safety competencies among nursing students and nursing interns. A descriptive, cross-sectional correlational design with a convenience sample of 154 participants (99 nursing students and 55 interns) completed the Self-assessment of Nursing Informatics Competencies and Patient Safety Competencies. The nursing students and interns were similar in age and years of computer experience, and more than half of the participants in both groups had taken a nursing informatics course. There were no significant differences between competencies in nursing informatics and patient safety except for clinical informatics role and applied computer skills in the two groups of participants. Nursing informatics competencies and patient safety competencies were significantly correlated except for clinical informatics role both with patient safety knowledge and attitude. These results provided feedback to adjust and incorporate informatics competencies in the baccalaureate program and to recommend embracing the nursing informatics course as one of the core courses, not as an elective course, in the curriculum.
Fuad, Anis; Sanjaya, Guardian Yoki; Lazuardi, Lutfan; Rahmanti, Annisa Ristya; Hsu, Chien-Yeh
Public health informatics has been defined as the systematic application of information and computer science and technology to public health practice, research, and learning . Unfortunately, limited reports exist concerning to the capacity building strategies to improve public health informatics workforce in limited-resources setting. In Indonesia, only three universities, including Universitas Gadjah Mada (UGM), offer master degree program on related public health informatics discipline. UGM started a new dedicated master program on Health Management Information Systems in 2005, under the auspice of the Graduate Program of Public Health at the Faculty of Medicine. This is the first tracer study to the alumni aiming to a) identify the gaps between curriculum and the current jobs and b) describe their perception on public health informatics competencies. We distributed questionnaires to 114 alumni with 36.84 % response rate. Despite low response rate, this study provided valuable resources to set up appropriate competencies, curriculum and capacity building strategies of public health informatics workforce in Indonesia.
Bates, D W
The costs of care in the U.S. are very high, in part because canre is relatively uncoordinated. To begin to address this and other issues, health care reform was passed, including the notion of accountable care. Under acountable care arrangements, providers are at risk for the costs of the care they provide to groups of patients. Evaluation of costs has made it clear that a large proportion of these costs are in the post-acute setting, and also that many specific problems such as adverse events and unnecessary readmissions occur following transitions. However, the electronic health records of today do not provide a great deal of assistance with the coordination of care, and even the best organizations have relatively primitive systems with respect to care coordination, even though communication is absolutely central to better coordination of care and health information technology (HIT) is a powerful lever for improving communication. This paper identifies specific gaps in care coordination today, presents a framework for better coordinating care using HIT, then describes how specific technologies can be leveraged. Also discussed are the need to build and test specific interventions to improve HIT-related care coordination tools, and the key policy steps needed to accomplish this.
Monteiro, Ana Paula Teixeira de Almeida Vieira
Nursing Sciences are at a moment of paradigmatic transition. The aim of this paper is to reflect on the new epistemological paradigms of nursing science from a critical approach. In this paper, we identified and analysed some new research lines and trends which anticipate the reorganization of nursing sciences and the paradigms emerging from nursing care: biotechnology-centred knowledge; the interface between nursing knowledge and new information technologies; body care centred knowledge; the human body as a cyborg body; and the rediscovery of an aesthetic knowledge in nursing care.
Knowledge for medicine and health care--laudation at the occasion of the honorary doctorate bestowed to Donald A. B. Lindberg by UMIT, University for Health Sciences, Medical Informatics and Technology in Innsbruck, Tyrol, Austria.
van Bemmel, Jan H
Dr. Donald A. B. Lindberg, Director of the U.S. National Library of Medicine, received an honorary doctorate from UMIT, the University for Health Sciences, Medical Informatics and Technology in Innsbruck, Tyrol. The celebration took place on September 28, 2004 at an academic event during a conference of the Austrian, German, and Swiss Societies of Medical Informatics, GMDS2004. Dr. Lindberg has been a pioneer in the field of computers in health care from the early 1960s onwards. In 1984 he became the Director of the National Library of Medicine in Bethesda, the world's largest fully computerized biomedical library. Dr. Lindberg has been involved in the early activities of the International Medical Informatics Association (IMIA), among others being the chair of the Organizing Committee for MEDINFO 86 in Washington D.C. He was elected the first president of the American Medical Informatics Association (AMIA), and served as an editor of Methods of Information in Medicine.
Malmqvist, Stefan; Leboeuf-Yde, Charlotte
of maintenance care. Previous studies have identified chiropractors' choices of case management strategies in response to different case scenarios. However, the rationale for these management strategies is not known. In other words, when presented with both the case, and different management strategies......Maintenance care is a well known concept among chiropractors, although there is little knowledge about its exact definition, its indications and usefulness. As an initial step in a research program on this phenomenon, it was necessary to identify chiropractors' rationale for their use......, there was consensus on how to match these, but if only the management strategies were provided, would chiropractors be able to define the cases to fit these strategies? The objective with this study was to investigate if there is a common pattern in Finnish chiropractors' case management of patients with low back...
The 13(th) World Congress on Medical and Health Informatics (Medinfo) was held in 2010 between 12 and 15 September in Cape Town, South Africa. This triennial international gathering is the official conference of the International Medical Informatics Association (IMIA) and brings together leading health informatics leaders, scientists, clinicians, researchers, vendors, developers and government and health care planners from around the globe. The conference attracted 905 submissions and resulted in a program that included 260 oral presentations, 349 posters presentations and 21 scientific demonstrations representing contributions from 58 countries. The Medinfo program covered all aspects of health informatics from traditional areas, such as hospital information systems, patient registries, nursing informatics, data integration, standards, interoperability issues and decision support, to innovative topics, such as translational bioinformatics, text mining, intelligent data analysis, emerging technologies, quality, social networking, workflow and organizational issues. The outgoing President of the IMIA, Professor Reinhold Haux, presented on health informatics challenges into the future, reinforcing that today and in the future, health care has to be considered as part of a continuous and coordinated life-time journey and not just as episodes of disease. Medical informatics has a key role to play in this paradigm shift. The new IMIA President, Professor Antoine Geissbuhler, was announced at the closing ceremony. The next Medinfo congress will take place in Copenhagen, Denmark, in September 2013.
Healthcare information technologies are now routinely deployed in a variety of healthcare contexts. These contexts differ widely, but the smooth integration of IT systems is crucial, so the design, implementation, and evaluation of safe, effective, efficient and easy to adopt health informatics...... involves careful consideration of both human and organizational factors. This book presents the proceedings of the Context Sensitive Health Informatics (CSHI) conference, held in Copenhagen, Denmark, in August 2013. The theme of this year’s conference is human and sociotechnical approaches. The Human......: patients and IT; usability test and evaluation; work tasks and related contexts; human factors and simulation; and context and systems design, and outline theories and models for studying contextual issues and insights related to how health information technologies can be better designed to accommodate...
Conclusion The MoleMateTM training program is a potentially effective and acceptable informatics tool to teach practitioners to recognise the features of SPLs identified by the MoleMateTM system. It will be used as part of the intervention in a randomised controlled trial to compare the diagnostic accuracy and appropriate referral rates of practitioners using the MoleMateTM system with best practice in primary care.
Kaltoft, Mette Kjer
All healthcare visions, including that of The TIGER (Technology-Informatics-Guiding-Educational-Reform) Initiative envisage a crucial role for nursing. However, its 7 descriptive pillars do not address the disconnect between Nursing Informatics and Nursing Ethics and their distinct communities......-of-(care)-decision. Increased pressure for translating 'evidence-based' research findings into 'ethically-sound', 'value-based' and 'patient-centered' practice requires rethinking the model implicit in conventional knowledge translation and informatics practice in all disciplines, including nursing. The aim is to aid 'how...... nurses and other health care scientists more clearly identify clinical and other relevant data that can be captured to inform future comparative effectiveness research. 'A prescriptive, theory-based discipline of '(Nursing) Decisionics' expands the Grid for Volunteer Development of TIGER's newly launched...
Turley, James P
This paper examines the historical definitions of Health (Biomedical) Informatics. It is clear that a majority of the definitions refer to Health Informatics as a discipline. Rather it can be argued that the maturation of Health Informatics is beginning to culminate in a distinct science. This progress need to be reflected in academic programs as well as our conferences and publications.
Hawkeye Area Community Action Program, Cedar Rapids, IA.
This report describes ways in which older persons may become involved in the field of home child care. It is intended to provide (1) detailed information on an intergenerational child care (IGCC) program; (2) general information relating to intergenerational contacts and home child care; and (3) "how-to" information for agencies planning…
Carefully engineered playable games can serve as vehicles for students and practitioners to learn and explore the programming of advanced computer architectures to execute applications, such as high performance computing (HPC) and complex, inter-networked, distributed systems. The article presents families of playable games that are grounded in…
Myburgh, Corrie; Brandborg-Olsen, Dorthe; Albert, Hanne;
To describe and interpret Danish Chiropractors' perspectives regarding the purpose and rationale for using MC (maintenance care), its content, course and patient characteristics.......To describe and interpret Danish Chiropractors' perspectives regarding the purpose and rationale for using MC (maintenance care), its content, course and patient characteristics....
Full Text Available The state-of-the-art programming of parallel computers is far from being successful. The main challenge today is, therefore, the development of techniques and tools that improve programmers' productivity. Programmability, portability, and reusability are key issues to be solved. In this article we shall report about our ongoing efforts in this direction. After a short discussion of the software dilemma found today, we shall present the Basel approach. We shall summarize our algorithm description methodology and discuss the basic concepts of the proposed skeleton language. An algorithmic example and comments on implementation aspects will explain our work in more detail. We shall summarize the current state of the implementation and conclude with a discussion of related work.
D'Souza, Malcolm J; Kashmar, Richard J; Hurst, Kent; Fiedler, Frank; Gross, Catherine E; Deol, Jasbir K; Wilson, Alora
Wesley College is a private, primarily undergraduate minority-serving institution located in the historic district of Dover, Delaware (DE). The College recently revised its baccalaureate biological chemistry program requirements to include a one-semester Physical Chemistry for the Life Sciences course and project-based experiential learning courses using instrumentation, data-collection, data-storage, statistical-modeling analysis, visualization, and computational techniques. In this revised curriculum, students begin with a traditional set of biology, chemistry, physics, and mathematics major core-requirements, a geographic information systems (GIS) course, a choice of an instrumental analysis course or a statistical analysis systems (SAS) programming course, and then, students can add major-electives that further add depth and value to their future post-graduate specialty areas. Open-sourced georeferenced census, health and health disparity data were coupled with GIS and SAS tools, in a public health surveillance system project, based on US county zip-codes, to develop use-cases for chronic adult obesity where income, poverty status, health insurance coverage, education, and age were categorical variables. Across the 48 contiguous states, obesity rates are found to be directly proportional to high poverty and inversely proportional to median income and educational achievement. For the State of Delaware, age and educational attainment were found to be limiting obesity risk-factors in its adult population. Furthermore, the 2004-2010 obesity trends showed that for two of the less densely populated Delaware counties; Sussex and Kent, the rates of adult obesity were found to be progressing at much higher proportions when compared to the national average.
... Strategic Plan Federal Initiatives Career Opportunities Contact Us Administration on Aging (AoA) Long-Term Care Ombudsman Program ( ... Prevention HIV/AIDS Nutrition Services Oral Health Elder Justice & Adult Protective Services Elder Justice Coordinating Council Prevention ...
Sánchez-Mendiola, Melchor; Martínez-Franco, Adrián I; Rosales-Vega, Argelia; Villamar-Chulin, Joel; Gatica-Lara, Florina; García-Durán, Rocío; Martínez-González, Adrián
Biomedical informatics (BMI) competencies are recognized as core requirements for the healthcare professional, but the amount of BMI educational interventions in the curricula of medical schools is limited. UNAM Faculty of Medicine in Mexico is a large public medical school, with more than 7000 undergraduate students. The undergraduate program recently underwent a major curricular revision, which includes BMI education. Two one-semester BMI courses (BMI-1 and BMI-2) were designed, with a blended-learning educational model. A department of BMI was created, with budget, offices and personnel. The first class of 1199 students started the course in 2010, with 32 groups of 40 students each. BMI-1 includes core conceptual notions of informatics applied to medicine (medical databases, electronic health record, telemedicine, among other topics), and BMI-2 embodies medical decision making and clinical reasoning. The program had a positive evaluation by students and teachers. BMI can be successfully incorporated in a large-scale medical school program in a developing country, using a blended-learning model and organizational change strategies.
D'Avolio, Leonard W; Farwell, Wildon R; Fiore, Louis D
As is the case for environmental, ecological, astronomical, and other sciences, medical practice and research finds itself in a tsunami of data. This data deluge, due primarily to the introduction of digitalization in routine medical care and medical research, affords the opportunity for improved patient care and scientific discovery. Medical informatics is the subdiscipline of medicine created to make greater use of information in order to improve healthcare. The 4 areas of medical informatics research (information access, structure, analysis, and interaction) are used as a framework to discuss the overlap in information needs of comparative effectiveness research and potential contributions of medical informatics. Examples of progress from the medical informatics literature and the Veterans Affairs Healthcare System are provided.
Clemmer, Terry P.
The goal of medical informatics is to improve care. This requires the commitment and harmonious collaboration between the computer scientists and clinicians and an integrated database. The vision described is how medical information systems are going to impact the way medical care is delivered in the future.
""This book will be a terrific introduction to the field of clinical IT and clinical informatics"" -- Kevin Johnson ""Dr. Braunstein has done a wonderful job of exploring a number of key trends in technology in the context of the transformations that are occurring in our health care system"" -- Bob Greenes ""This insightful book is a perfect primer for technologists entering the health tech field."" -- Deb Estrin ""This book should be read by everyone."" -- David Kibbe This book provides care providers and other non-technical readers with a broad, practical overview of the changi
Simon de Lusignan
Conclusions We should make more efforts to share learning; develop clear internationally acceptable definitions; highlight gaps between pockets of excellence and real-world practice, and most importantly suggest how they might be bridged. Knowledge synthesis from different health systems may provide a greater understanding of how the third actor (the computer is best used in primary care.
Nursing informatics (NI) is a well-established specialty within nursing. Background on the birth and evolution of NI, and the NI scope of practice and certification are explored. NI has played a vital role in influencing health care information system features and functions. Today, nursing informatics has evolved to be an integral part of health care delivery and a differentiating factor in the selection, implementation, and evaluation of health IT that supports safe, high-quality, patient-centric care.
MacDougall, Jennifer; And Others
Reviews literature related to health informatics and health information management. Provides examples covering types of information, library and information services outcomes, training of informatics professionals, areas of application, the impact of evidence based medicine, professional issues, integrated information systems, and the needs of the…
Simon de Lusignan
Full Text Available After 20-years as Informatics in Primary Care the journal is renamed Journal of Innovation in Health Informatics. The title was carefully selected to reflect that:(1 informatics provides the opportunity to innovate rather than simply automates;(2 implementing informatics solutions often results in unintended consequences, and many implementations fail and benefits and innovations may go unrecognised;(3 health informatics is a boundary spanning discipline and is by its very nature likely to give rise to innovation.Informatics is an innovative science, and informaticians need to innovate across professional and discipline boundaries.
Telemedicine is a new adjunct to the delivery of health care services that has been applied to a range of health care specialties, including mental health. When prospective telemedicine programs are planned, telemedicine is often envisaged as simply a question of introducing new technology. The development of a robust, sustainable telemental health program involves clinical, technical, and managerial considerations. The major barriers to making this happen are usually how practitioners and patients adapt successfully to the technology and not in the physical installation of telecommunications bandwidth and the associated hardware necessary for teleconsultation. This article outlines the requirements for establishing a viable telemental health service, one that is based on clinical need, practitioner acceptance, technical reliability, and revenue generation. It concludes that the major challenge associated with the implementation of telemental health does not lie in having the idea or in taking the idea to the project stage needed for proof of concept. The major challenge to the widespread adoption of telemental health is paying sufficient attention to the myriad of details needed to integrate models of remote health care delivery into the wider health care system.
Ariño Arturo H
Full Text Available Abstract Background Biodiversity informatics is a relatively new discipline extending computer science in the context of biodiversity data, and its development to date has not been uniform throughout the world. Digitizing effort and capacity building are costly, and ways should be found to prioritize them rationally. The proposed 'Biodiversity Informatics Potential (BIP Index' seeks to fulfill such a prioritization role. We propose that the potential for biodiversity informatics be assessed through three concepts: (a the intrinsic biodiversity potential (the biological richness or ecological diversity of a country; (b the capacity of the country to generate biodiversity data records; and (c the availability of technical infrastructure in a country for managing and publishing such records. Methods Broadly, the techniques used to construct the BIP Index were rank correlation, multiple regression analysis, principal components analysis and optimization by linear programming. We built the BIP Index by finding a parsimonious set of country-level human, economic and environmental variables that best predicted the availability of primary biodiversity data accessible through the Global Biodiversity Information Facility (GBIF network, and constructing an optimized model with these variables. The model was then applied to all countries for which sufficient data existed, to obtain a score for each country. Countries were ranked according to that score. Results Many of the current GBIF participants ranked highly in the BIP Index, although some of them seemed not to have realized their biodiversity informatics potential. The BIP Index attributed low ranking to most non-participant countries; however, a few of them scored highly, suggesting that these would be high-return new participants if encouraged to contribute towards the GBIF mission of free and open access to biodiversity data. Conclusions The BIP Index could potentially help in (a identifying
Full Text Available Joshua Faucher,1 Jordan Rosedahl,2 Dawn Finnie,3 Amy Glasgow,3 Paul Takahashi4 1Mayo Medical School, Mayo Clinic College of Medicine, 2Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, 3Center for the Science of Health Care Delivery, 4Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA Background: Transitional care programs are common interventions aimed at reducing medical complications and associated readmissions for patients recently discharged from the hospital. While organizations strive to reduce readmissions, another important related metric is patient quality of life (QoL. Aims: To compare the relationship between QoL in patients enrolled in the Mayo Clinic Care Transitions (MCCT program versus usual care, and to determine if QoL changed in MCCT participants between baseline and 1-year follow-up. Methods: A baseline survey was mailed to MCCT enrollees in March 2013. Those who completed a baseline survey were sent a follow-up survey 1 year later. A cross-sectional survey of usual care participants was mailed in November 2013. We included in our analysis 199 participants (83 in the MCCT and 116 in usual care aged over 60 years with multiple comorbidities and receiving primary care. Primary outcomes were self-rated QoL; secondary outcomes included self-reported general, physical, and mental health. Intra- and intergroup comparisons of patients were evaluated using Pearson’s chi-squared analysis. Results: MCCT participants had more comorbidities and higher elder risk assessment scores than those receiving usual care. At baseline, 74% of MCCT participants reported responses of good-to-excellent QoL compared to 64% after 1 year (P=0.16. Between MCCT and usual care, there was no significant difference in self-reported QoL (P=0.21. Between baseline and follow-up in MCCT patients, and compared to usual care, there were no significant
Andrey A. Mayorov
Full Text Available In this article are considered the integrant importance of informatics and informational technologys includes the sciences and the humanities.There are a differences between scientifi c grounds of the various information orientations, which include physical informatics, bioinfomatics, technical and social informatics. Creation of a united theoretical base for these orientations is very problematical. The metodologically important issue of classifi cation different informatics is a part of the general informatics, the example of which are considered here.
Abraham, Ajith; Pal, Sankar; Rodriguez, Juan
This book constitutes the thoroughly refereed post-conference proceedings of the Second International Symposium on Intelligent Informatics (ISI 2013) held in Mysore, India during August 23-24, 2013. The 47 revised papers presented were carefully reviewed and selected from 126 initial submissions. The papers are organized in topical sections on pattern recognition, signal and image processing; data mining, clustering and intelligent information systems; multi agent systems; and computer networks and distributed systems. The book is directed to the researchers and scientists engaged in various fields of intelligent informatics.
Ostergren, Carol S.; Riley, David A.; Wehmeier, Jenny M.
More high quality child care is needed in the United States. This article evaluates the Better Kid Care (BKC) program produced by Pennsylvania State University Extension. Child care staff in Wisconsin were interviewed about changes they had made in their early childhood programs following participation in the BKC program. Findings show that 2…
Stephens, Samuel A.
Child care centers, Head Start programs, and family child care providers serving young children--as well as after school programs and homeless shelters that reach older children, adults, and families--are supported in providing healthy meals and snacks by reimbursements through the Child and Adult Care Food Program (CACFP). Administered by the…
Johnson-Throop, Kathy A.
To improve on-orbit clinical capabilities by developing and providing operational support for intelligent, robust, reliable, and secure, enterprise-wide and comprehensive health care and biomedical informatics systems with increasing levels of autonomy, for use on Earth, low Earth orbit & exploration class missions. Biomedical Informatics is an emerging discipline that has been defined as the study, invention, and implementation of structures and algorithms to improve communication, understanding and management of medical information. The end objective of biomedical informatics is the coalescing of data, knowledge, and the tools necessary to apply that data and knowledge in the decision-making process, at the time and place that a decision needs to be made.
Bernstam, Elmer V; Smith, Jack W; Johnson, Todd R
Biomedical informatics lacks a clear and theoretically-grounded definition. Many proposed definitions focus on data, information, and knowledge, but do not provide an adequate definition of these terms. Leveraging insights from the philosophy of information, we define informatics as the science of information, where information is data plus meaning. Biomedical informatics is the science of information as applied to or studied in the context of biomedicine. Defining the object of study of informatics as data plus meaning clearly distinguishes the field from related fields, such as computer science, statistics and biomedicine, which have different objects of study. The emphasis on data plus meaning also suggests that biomedical informatics problems tend to be difficult when they deal with concepts that are hard to capture using formal, computational definitions. In other words, problems where meaning must be considered are more difficult than problems where manipulating data without regard for meaning is sufficient. Furthermore, the definition implies that informatics research, teaching, and service should focus on biomedical information as data plus meaning rather than only computer applications in biomedicine.
Gyampoh-Vidogah, Regina; Moreton, Robert; Sallah, David
Health informatics has the potential to improve the quality and provision of care while reducing the cost of health care delivery. However, health informatics is often falsely regarded as synonymous with information management (IM). This chapter (i) provides a clear definition and characteristic benefits of health informatics and information management in the context of health care delivery, (ii) identifies and explains the difference between health informatics (HI) and managing knowledge (KM) in relation to informatics business strategy and (iii) elaborates the role of information communication technology (ICT) KM environment. This Chapter further examines how KM can be used to improve health service informatics costs, and identifies the factors that could affect its implementation and explains some of the reasons driving the development of electronic health record systems. This will assist in avoiding higher costs and errors, while promoting the continued industrialisation of KM delivery across health care communities.
Dutta-Moscato, Joyeeta; Gopalakrishnan, Vanathi; Lotze, Michael T; Becich, Michael J
This editorial provides insights into how informatics can attract highly trained students by involving them in science, technology, engineering, and math (STEM) training at the high school level and continuing to provide mentorship and research opportunities through the formative years of their education. Our central premise is that the trajectory necessary to be expert in the emergent fields in front of them requires acceleration at an early time point. Both pathology (and biomedical) informatics are new disciplines which would benefit from involvement by students at an early stage of their education. In 2009, Michael T Lotze MD, Kirsten Livesey (then a medical student, now a medical resident at University of Pittsburgh Medical Center (UPMC)), Richard Hersheberger, PhD (Currently, Dean at Roswell Park), and Megan Seippel, MS (the administrator) launched the University of Pittsburgh Cancer Institute (UPCI) Summer Academy to bring high school students for an 8 week summer academy focused on Cancer Biology. Initially, pathology and biomedical informatics were involved only in the classroom component of the UPCI Summer Academy. In 2011, due to popular interest, an informatics track called Computer Science, Biology and Biomedical Informatics (CoSBBI) was launched. CoSBBI currently acts as a feeder program for the undergraduate degree program in bioinformatics at the University of Pittsburgh, which is a joint degree offered by the Departments of Biology and Computer Science. We believe training in bioinformatics is the best foundation for students interested in future careers in pathology informatics or biomedical informatics. We describe our approach to the recruitment, training and research mentoring of high school students to create a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics. We emphasize here how mentoring of high school students in pathology informatics and biomedical informatics
Full Text Available This editorial provides insights into how informatics can attract highly trained students by involving them in science, technology, engineering, and math (STEM training at the high school level and continuing to provide mentorship and research opportunities through the formative years of their education. Our central premise is that the trajectory necessary to be expert in the emergent fields in front of them requires acceleration at an early time point. Both pathology (and biomedical informatics are new disciplines which would benefit from involvement by students at an early stage of their education. In 2009, Michael T Lotze MD, Kirsten Livesey (then a medical student, now a medical resident at University of Pittsburgh Medical Center (UPMC, Richard Hersheberger, PhD (Currently, Dean at Roswell Park, and Megan Seippel, MS (the administrator launched the University of Pittsburgh Cancer Institute (UPCI Summer Academy to bring high school students for an 8 week summer academy focused on Cancer Biology. Initially, pathology and biomedical informatics were involved only in the classroom component of the UPCI Summer Academy. In 2011, due to popular interest, an informatics track called Computer Science, Biology and Biomedical Informatics (CoSBBI was launched. CoSBBI currently acts as a feeder program for the undergraduate degree program in bioinformatics at the University of Pittsburgh, which is a joint degree offered by the Departments of Biology and Computer Science. We believe training in bioinformatics is the best foundation for students interested in future careers in pathology informatics or biomedical informatics. We describe our approach to the recruitment, training and research mentoring of high school students to create a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics. We emphasize here how mentoring of high school students in pathology informatics and biomedical
Web 3.0 promises us smart computer services that will interact with each other and leverage knowledge about us and our immediate context to deliver prioritised and relevant information to support decisions and actions. Healthcare must take advantage of such new knowledge-integrating services, in particular to support better co-operation between professionals of different disciplines working in different locations, and to enable well-informed co-operation between clinicians and patients. To grasp the potential of Web 3.0 we will need well-harmonised semantic resources that can richly connect virtual teams and link their strategies to real-time and tailored evidence. Facts, decision logic, care pathway steps, alerts, education need to be embedded within components that can interact with multiple EHR systems and services consistently. Using Health Informatics 3.0 a patient's current situation could be compared with the outcomes of very similar patients (from across millions) to deliver personalised care recommendations. The integration of EHRs with biomedical sciences ('omics) research results and predictive models such as the Virtual Physiological Human could help speed up the translation of new knowledge into clinical practice. The mission, and challenge, for Health Informatics 3.0 is to enable healthy citizens, patients and professionals to collaborate within a knowledge-empowered social network in which patient specific information and personalised real-time evidence are seamlessly interwoven.
Zimmerman, J L; van Bemmel, J H; Rienhoff, O
Medical informatics is still in its early stages of evolution and definition. If informatics is to obtain the status of a specialized field of study within the health science curriculum, its ambiguity must be eliminated. This article discusses the term "medical informatics" and the impact of the new field of study on curriculum, education, and training of health care professionals, and health care information systems research and development.
Jodha, Siri; Khalsa, S.; Ramachandran, Rahul
The volume and complexity of Earth science data have steadily increased, placing ever-greater demands on researchers, software developers and data managers tasked with handling such data. Additional demands arise from requirements being levied by funding agencies and governments to better manage, preserve and provide open access to data. Fortunately, over the past 10-15 years significant advances in information technology, such as increased processing power, advanced programming languages, more sophisticated and practical standards, and near-ubiquitous internet access have made the jobs of those acquiring, processing, distributing and archiving data easier. These advances have also led to an increasing number of individuals entering the field of informatics as it applies to Geoscience and Remote Sensing. Informatics is the science and technology of applying computers and computational methods to the systematic analysis, management, interchange, and representation of data, information, and knowledge. Informatics also encompasses the use of computers and computational methods to support decisionmaking and other applications for societal benefits.
Parker, Michael D.
Examined effects of a pilot voucher program on the price, supply, and quality of day care. Findings offered no conclusive evidence concerning expected benefits. Discusses vouchers' potential for easing the day care crisis. (RJC)
Richesson, Rachel L
This book provides foundational coverage of key areas, concepts, constructs, and approaches of medical informatics as it applies to clinical research activities, in both current settings and in light of emerging policies. The field of clinical research is fully characterized (in terms of study design and overarching business processes), and there is emphasis on information management aspects and informatics implications (including needed activities) within various clinical research environments. The purpose of the book is to provide an overview of clinical research (types), activities, and are
Pedretti, Alessandro; Villa, Luigi; Vistoli, Giulio
In this paper we present the expandability and flexibility features of the VEGA program (downloadable free of charge at http://www.ddl.unimi.it), for the development of custom applications, using it as a multipurpose graphical environment. VEGA can be customized using both plug-in architecture and script programming. The first is useful to add new features and functions, using homemade routines, written with the VEGA Plug-in Development Kit (SDK). With the second approach it is possible to design scripts in VEGA, using the REBOL language, in order to (1) add new functions or customize existing ones; (2) automate common procedures; and (3) allow network communications, by creating a bridge between VEGA and other applications (or other PCs) through the TCP/IP protocol.
Breil, Bernhard; Fritz, Fleur; Thiemann, Volker; Dugas, Martin
Design and implementation of healthcare information systems affect both computer scientists and health care professionals. In this paper we present our approach to integrate the management of information systems in the education of healthcare professionals and computer scientists alike. We designed a multidisciplinary course for medical and informatics students to provide them with practical experience concerning the design and implementation of medical information systems. This course was implemented in the curriculum of the University of Münster in 2009. The key element is a case study that is performed by small teams of medical and informatics students. A practical course on management of information systems can be useful for medical students who want to enhance their knowledge in information systems as well as for informatics students with particular interests in medicine.
Robertson, Hamish; Nicholas, Nick; Georgiou, Andrew; Johnson, Julie; Travaglia, Joanne
Health systems globally are undergoing significant changes. New systems are emerging in developing countries where there were previously limited healthcare options, existing systems in emerging and developed economies are under significant resource pressures and population dynamics are creating significant pressures for change. As health systems expand and intensify, information quality and timeliness will be central to their sustainability and continuity. Information collection and transfer across diverse systems and international borders already presents a significant challenge for health system operations and logistics. Geographic information science (giscience) has the potential to support and enhance health informatics in the coming decades as health information transfers become increasingly important. In this article we propose a spatially enabled approach to support and increasingly globalised health informatics environment. In a world where populations are ageing and urbanising and health systems are linked to economic and social policy shifts, knowing where patients, diseases, health care workers and facilities are located becomes central to those systems operational capacities. In this globalising environment, health informatics needs to be spatially enabled informatics.
Larsen, Jakob Eg; E. Froehlich, Jon; Kay, Matthew;
, methodologies, study designs, and technologies are frequently not disclosed. This is a missed opportunity, particularly for nascent areas like Personal Informatics (PI) as well as other research areas, more generally, that share high costs in time, development, and recruitment for building and deploying...
Blank, Jerome W.; Popovich, Nicholas G.
The Purdue University School of Pharmacy and Pharmacal Sciences initiated a Certificate Program in Self-Care for Pharmacy Practice. The program aimed to enable pharmacists to develop their practice to better serve the self-care needs of customers. In a pilot group 26 participating pharmacists took a sequence of home study modules and workshops…
Martini, Gilbert R., Jr.
A wellness program is a formalized approach to preventive health care that can positively affect employee lifestyle and reduce future health-care costs. Describes programs for health education, smoking cessation, early detection, employee assistance, and fitness, citing industry success figures. (eight references) (MLF)
Full Text Available Biodiversity Informatics is a young and rapidly growing field that brings information science and technologies to bear on the data and information generated by the study of biodiversity and related subjects. Recent years, biodiversity informatics community has made an extraordinary effort to digitize primary biodiversity data, and develop modelling tools, data integration, and county/ regional/ global biodiversity networks. In doing so, the community is creating an unprecedented global sharing of information and data produced by biodiversity science, and encouraging people to consider, survey and monitor natural biodiversity. Due to success of several international biodiversity informatics projects, such as Species 2000, Global Biodiversity Information Facility, Barcoding of Life and Encyclopedia of Life, digitized information on species inventories, herbarium specimens, multimedia and literature is available through internet. These projects not only make great contributions to sharing digitized biodiversity data, but also in prompting the implementation of important biodiversity information standards, such as Darwin Core, and in the establishment of regional and national biodiversity networks. These efforts will facilitate the future establishment of a strong information infrastructure for data sharing and exchange at a global scale. Besides focusing on browsing and searching digitized data, scientists should also work on building data mining and modeling, such as MAXENT for Ecological Niche Modelling and LifeDesk for taxonomist’s knowledge management. At the same time, the idea of citizen sciences gains popularity showing us the benefit of the public working closely with the scientific community in completing internet-based biodiversity informatics activities. Therefore, biodiversity informatics has broad prospects, and is helping to build strong facilities that will aid in implementing the goals set by Global Plant Conservation Strategy and
Watnick, Suzanne; Weiner, Daniel E; Shaffer, Rachel; Inrig, Jula; Moe, Sharon; Mehrotra, Rajnish
In addition to extending health insurance coverage, the Affordable Care Act of 2010 aims to improve quality of care and contain costs. To this end, the act allowed introduction of bundled payments for a range of services, proposed the creation of accountable care organizations (ACOs), and established the Centers for Medicare and Medicaid Innovation to test new care delivery and payment models. The ACO program began April 1, 2012, along with demonstration projects for bundled payments for episodes of care in Medicaid. Yet even before many components of the Affordable Care Act are fully in place, the Medicare ESRD Program has instituted legislatively mandated changes for dialysis services that resemble many of these care delivery reform proposals. The ESRD program now operates under a fully bundled, case-mix adjusted prospective payment system and has implemented Medicare's first-ever mandatory pay-for-performance program: the ESRD Quality Incentive Program. As ACOs are developed, they may benefit from the nephrology community's experience with these relatively novel models of health care payment and delivery reform. Nephrologists are in a position to assure that the ACO development will benefit from the ESRD experience. This article reviews the new ESRD payment system and the Quality Incentive Program, comparing and contrasting them with ACOs. Better understanding of similarities and differences between the ESRD program and the ACO program will allow the nephrology community to have a more influential voice in shaping the future of health care delivery in the United States.
Anholt, R M; Berezowski, J; Maclean, K; Russell, M L; Jamal, I; Stephen, C
Companion animals closely share their domestic environment with people and have the potential to, act as sources of zoonotic diseases. They also have the potential to be sentinels of infectious and noninfectious, diseases. With the exception of rabies, there has been minimal ongoing surveillance of, companion animals in Canada. We developed customized data extraction software, the University of, Calgary Data Extraction Program (UCDEP), to automatically extract and warehouse the electronic, medical records (EMR) from participating private veterinary practices to make them available for, disease surveillance and knowledge creation for evidence-based practice. It was not possible to build, generic data extraction software; the UCDEP required customization to meet the specific software, capabilities of the veterinary practices. The UCDEP, tailored to the participating veterinary practices', management software, was capable of extracting data from the EMR with greater than 99%, completeness and accuracy. The experiences of the people developing and using the UCDEP and the, quality of the extracted data were evaluated. The electronic medical record data stored in the data, warehouse may be a valuable resource for surveillance and evidence-based medical research.
实施全民参保计划是“十三五”时期社会保障工作的重要任务。从信息化角度，保障全民参保计划实施，重点抓好四个方面，一是建设全民参保登记系统，畅通参保登记渠道，登记未参保人员，促进参保；二是完善联网监测系统，建设持卡人员基础信息库，共享数据，标记未参全人员，查清补齐，推进参保；三是推动社会保险关系转移系统建设应用，实现社保关系顺畅接转，促进续保；四是利用比对查询系统，归并去重，消除重复参保。%The implementation of National Insurance Program is an important task of social security system during the “13th fi ve-year plan” period. From the view of information construction, to ensure the implementation of the National Insurance Plan, we should focus on the followings four aspects. Firstly, we should construct a national insurance registration system to keep the registration channels unblocked, and should registry non-insured person to promote their participating. Secondly, we should improve the network monitoring system, build a basic information database of the cardholder for data sharing, and mark the non-insured person to promote them participating in social insurance. Thirdly, we should construct a social insurance relationship transferring system to ensure smooth transfer and renewal of insurance. Fourthly, we should use comparison and searching system to merge and eliminate overlapped insurance data.
Stead, William W; Searle, John R; Fessler, Henry E; Smith, Jack W; Shortliffe, Edward H
The explosive growth of biomedical complexity calls for a shift in the paradigm of medical decision making-from a focus on the power of an individual brain to the collective power of systems of brains. This shift alters professional roles and requires biomedical informatics and information technology (IT) infrastructure. The authors illustrate this future role of medical informatics with a vignette and summarize the evolving understanding of both beneficial and deleterious effects of informatics-rich environments on learning, clinical care, and research. The authors also provide a framework of core informatics competencies for health professionals of the future and conclude with broad steps for faculty development. They recommend that medical schools advance on four fronts to prepare their faculty to teach in a biomedical informatics-rich world: (1) create academic units in biomedical informatics; (2) adapt the IT infrastructure of academic health centers (AHCs) into testing laboratories; (3) introduce medical educators to biomedical informatics sufficiently for them to model its use; and (4) retrain AHC faculty to lead the transformation to health care based on a new systems approach enabled by biomedical informatics. The authors propose that embracing this collective and informatics-enhanced future of medicine will provide opportunities to advance education, patient care, and biomedical science.
Spencer, Julie A
Informatics education must prepare today's nurses to manage a deluge of information and use technology effectively. In addition, U.S. health care is being redesigned with technology that improves patient safety and quality of care. The Institute of Medicine's recommendations for health care safety and professional education prompted initiatives by the National League for Nursing, the American Association of Colleges of Nursing, and others to make informatics a fundamental part of nursing education. The Quality and Safety Education for Nurses (QSEN) project outlines specific competency goals for informatics knowledge, skills, and attitudes. However, progress toward integration of informatics in nursing curricula has been slow, and additional strategies need further exploration and discussion in the nursing literature. This article uses the QSEN framework to present strategies for teaching multiple facets of informatics in the classroom, simulation laboratory, and clinical settings in a baccalaureate nursing curriculum.
Grant, Marcia; McCorkle, Ruth; Hornbrook, Mark C; Wendel, Christopher S; Krouse, Robert
Each year a percentage of the 1.2 million men and women in the United States with a new diagnosis of colorectal cancer join the 700,000 people who have an ostomy. Education targeting the long-term, chronic care of this population is lacking. This report describes the development of a Chronic Care Ostomy Self-Management Program, which was informed by (1) evidence on published quality-of-life changes for cancer patients with ostomies, (2) educational suggestions from patients with ostomies, and (3) examination of the usual care of new ostomates to illustrate areas for continued educational emphases and areas for needed education and support. Using these materials, the Chronic Care Ostomy Self-Management Program was developed by a team of multi-disciplinary researchers accompanied by experienced ostomy nurses. Testing of the program is in process. Pilot study participants reported high satisfaction with the program syllabus, ostomy nurse leaders, and ostomate peer buddies.
... information technology, e.g., permitting electronic submission of responses. The proposed amendments to title... counseling. (2) Professional counseling, including counseling on self care skills, adaptive coping skills and, as appropriate, vocational rehabilitation counseling, in collaboration with VA programs and...
The Lithuanian Informatics Olympiads (LitIO) is a problem solving programming contest for students in secondary education. The work of the student to be evaluated is an algorithm designed by the student and implemented as a working program. The current evaluation process involves both automated (for correctness and performance of programs with the…
... condition that poses a threat to children's health. Family child care providers must ensure that pets are... 45 Public Welfare 4 2010-10-01 2010-10-01 false Family child care program option. 1306.35 Section... SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES,...
Spellman, Douglas F.; Griffith, Annette K.; Huefner, Jonathan C.; Wise, Neil, III; McElderry, Ellen; Leslie, Laurel K.
This article presents a psychotropic medication management approach that is used within a residential care program. The approach is used to assess medications at youths' times of entry and to facilitate decision making during care. Data from a typical case study have indicated that by making medication management decisions slowly, systematically,…
Spielberger, Julie; Zanoni, Wladimir; Barisik, Elizabeth
As a result of policy changes following welfare reform in 1996 and the costs associated with providing high-quality early care and education for children of low-income working families, agency collaboration in the state of Illinois has become an increasingly salient feature of subsidized early care and education programs (SECE). The authors…
Licurse, Mindy Y.; Cook, Tessa S.
Radiology and imaging informatics education have rapidly evolved over the past few decades. With the increasing recognition that future growth and maintenance of radiology practices will rely heavily on radiologists with fundamentally sound informatics skills, the onus falls on radiology residency programs to properly implement and execute an informatics curriculum. In addition, the American Board of Radiology may choose to include even more informatics on the new board examinations. However, the resources available for didactic teaching and guidance most especially at the introductory level are widespread and varied. Given the breadth of informatics, a centralized web-based interface designed to serve as an adjunct to standardized informatics curriculums as well as a stand-alone for other interested audiences is desirable. We present the development of a curriculum using PearlTrees, an existing web-interface based on the concept of a visual interest graph that allows users to collect, organize, and share any URL they find online as well as to upload photos and other documents. For our purpose, the group of "pearls" includes informatics concepts linked by appropriate hierarchal relationships. The curriculum was developed using a combination of our institution's current informatics fellowship curriculum, the Practical Imaging Informatics textbook1 and other useful online resources. After development of the initial interface and curriculum has been publicized, we anticipate that involvement by the informatics community will help promote collaborations and foster mentorships at all career levels.
Tennant, J; Narayan, M C
Comprehensive night service by a home care agency has resulted in increased customer satisfaction and referrals to the agency. The description of this innovative night nurse program includes the job requirements and duties of a visiting night nurse and the tools the nurse uses to accomplish the task of nighttime care delivery. The use of self-directed work groups and mentorship to manage the demands of night service are discussed. Continuity of care, nurse safety, professional development, and program cost also are addressed.
Jerant, Anthony F.
Describes an eight-step process for developing or refining a family-medicine informatics curriculum: needs assessment, review of expert recommendations, enlisting faculty and local institutional support, espousal of a human-centered approach, integrating informatics into the larger curriculum, easy access to computers, practical training, and…
Kamal, Arif H; Currow, David C; Ritchie, Christine; Bull, Janet; Wheeler, Jane L; Abernethy, Amy P
Collecting reliable and valid data is an increasing expectation within palliative care. Data remain the crux for demonstrating value and quality of care, which are the critical steps to program sustainability. Parallel goals of conducting research and performing quality assessment and improvement can also ensure program growth, financial health, and viability in an increasingly competitive environment. Mounting expectations by patients, hospitals, and payers and inevitable pay-for-performance paradigms have transitioned data collection procedures from novel projects to expected standard operation within usual palliative care delivery. We present types of data to collect, published guides for data collection, and how data can inform quality, value, and research within a palliative care organization. Our experiences with the Quality Data Collection Tool (QDACT) in the Carolinas Palliative Care Consortium to collect data on quality have led to valuable lessons learned in creating a data collection system. Suggested steps in forming data-sharing collaborations and building data collection procedures are shared.
Full Text Available Automation and emerging information technologies are being adopted by cytology laboratories to augment Pap test screening and improve diagnostic accuracy. As a result, informatics, the application of computers and information systems to information management, has become essential for the successful operation of the cytopathology laboratory. This review describes how laboratory information management systems can be used to achieve an automated and seamless workflow process. The utilization of software, electronic databases and spreadsheets to perform necessary quality control measures are discussed, as well as a Lean production system and Six Sigma approach, to reduce errors in the cytopathology laboratory.
Context is a key consideration when designing and evaluating health information technology (HIT) and cannot be overstated. Unintended consequences are common post HIT implementation and even well designed technology may not achieve desired outcomes because of contextual issues. While context should...... be considered in the design and evaluation of health information systems (HISs) there is a shortcoming of empirical research on contextual aspects of HIT. This conference integrates the sociotechnical and Human-Centered-Design (HCD) approaches and showcases current research on context sensitive health...... informatics. The papers and presentations outlines theories and models for studying contextual issues and insights on how we can better design HIT to accommodate different healthcare contexts....
Twomey, Jean E.; Caldwell, Donna; Soave, Rosemary; Fontaine, Lynne Andreozzi; Lester, Barry M.
The Vulnerable Infants Program of Rhode Island (VIP-RI) was established as a care coordination program to promote permanency for substance-exposed newborns in the child welfare system. Goals of VIP-RI were to optimize parents' opportunities for reunification and increase the efficacy of social service systems involved with families affected by…
program areas such as nutri- tion, health, child growth and development, educational guidance, and remedial techniques. None of the existing service...activities weakens their programs. The child care staff should know about such things as nutri- tion, health, child growth and development
Full Text Available Realistic multimedia simulations are effective in helping students overcome their fear of physics and gain fundamental knowledge of physical processes. An elective course has been designed in the Applied Informatics and Multimedia Department at TEI of Crete to help informatics students overcome their physics shyness by hands-on experience on scientific multimedia simulations. The approach is justified in terms of the rich employment opportunities in the game and multimedia industries where a sound basis in physics, mathematics and numerical analysis is a necessity. Student feedback shows that they embrace the adopted approach, which uses open source tools to minimize programming so as to allow both instructor and students to focus on the science and complete a greater number of simulations.
Chhabra, Kumar Gaurav; Mulla, Salma H; Deolia, Shravani Govind; Chhabra, Chaya; Singh, Jagjeet; Marwaha, Baldeep Singh
Dental informatics is comparatively a juvenile and new field that has noteworthy potential for supporting clinical care, research, education and management. This field utilizes computer science, information sciences and the application of same to espouse dentistry. However, in the under-developed and developing countries almost most of the dentists are unacquainted about dental informatics, its goals, what it is capable of achieving and by what means they can get involved into it. Despite of emerging advances, certain conflicts also go along with it such as, professional under representation, security issues of the stored information due to universal access to computers high speed internet connections. Endnote software was used as resource material to collect literature which was carefully arranged in a synchronized way. Hence, the purpose of this review was to give an overall scenario of dental informatics, its applications, challenges and recommendations for further enhancement in this area.
Sabin, James E; Cochran, David
Patients, providers, and policy leaders need a new moral compass to guide them in the turbulent U.S. health care system. Task forces have proposed excellent ethical codes, but these have been seen as too abstract to provide guidance at the front lines. Harvard Pilgrim Health Care's ten-year experience with an organizational ethics program suggests ways in which health care organizations can strengthen transparency, consumer focus, and overall ethical performance and contribute to the national health policy dialogue.
van Bemmel, J H; McCray, A T
The promise of the field of Medical Informatics has been great and its impact has been significant. In 1999, the Yearbook editors of the International Medical Informatics Association (IMIA) - also the authors of the present paper - sought to assess this impact by selecting a number of seminal papers in the field, and asking experts to comment on these articles. In particular, it was requested whether and how the expectations, represented by these papers, had been fulfilled since their publication several decades earlier. Each expert was also invited to comment on what might be expected in the future. In the present paper, these areas are briefly reviewed again. Where did these early papers have an impact and where were they not as successful as originally expected? It should be noted that the extraordinary developments in computer technology observed in the last two decades could not have been foreseen by these early researchers. In closing, some of the possibilities and limitations of research in medical informatics are outlined in the context of a framework that considers six levels of computer applications in medicine and health care. For each level, some predictions are made for the future, concluded with thoughts on fruitful areas for ongoing research in the field.
Christensen, Lisa Bøge; Hede, Børge; Petersen, Poul Erik
) payment of service, (4) providers of oral health care, (5) special training of staff, 6) dental services delivered, (7) ethical issues, and (8) patient rights. Less than one-third of persons estimated by the health authorities were enrolled in the program. On average, 0.4% of the municipal population...... attended the program, ranging from 0.03% to 1.53%. In large municipalities, and where internal providers delivered oral health care, relatively more persons were enrolled in the program (p ...The objectives of the study were (1) to describe the organization and content of the Danish public oral health care program for persons with disability, and (2) to analyse possible variations in relation to the goals and requirements set by the health authorities. Data were collected by means...
Zhen-ming XIE; Hong-yan LIU
Objective To sum up the theory of quality care according to the experience of F.P. program in China.Methods The author summarized the QOC theory and draw on its experiences and strength in family planning program in China.Results The theory facilitated the earnest program of the population and family planning program during the tenth five-year plan period, benefited the realization of the innovation of system and mechanism in population and family planning work, and the creation of a nice population environment for the healthy social and economic development in China.Conclusion The development of QOC has displayed a conspicuous theory in China's family planning program.
Full Text Available Leah L Zullig,1,2 Hayden B Bosworth1–4 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 2Department of Medicine, Duke University Medical Center, Durham, NC, USA; 3School of Nursing, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA Abstract: Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities. Keywords: program sustainability, diffusion of innovation, information dissemination, health services research, intervention studies
Rocque, Gabrielle B; Partridge, Edward E; Pisu, Maria; Martin, Michelle Y; Demark-Wahnefried, Wendy; Acemgil, Aras; Kenzik, Kelly; Kvale, Elizabeth A; Meneses, Karen; Li, Xuelin; Li, Yufeng; Halilova, Karina I; Jackson, Bradford E; Chambless, Carol; Lisovicz, Nedra; Fouad, Mona; Taylor, Richard A
The Patient Care Connect Program (PCCP) is a lay patient navigation program, implemented by the University of Alabama at Birmingham Health System Cancer Community Network. The PCCP's goal is to provide better health and health care, as well as to lower overall expenditures. The program focuses on enhancing the health of patients, with emphasis on patient empowerment and promoting proactive participation in health care. Navigator training emphasizes palliative care principles and includes development of skills to facilitate advance care planning conversations. Lay navigators are integrated into the health care team, with the support of a nurse supervisor, physician medical director, and administrative champion. The intervention focuses on patients with high needs to reach those with the greatest potential for benefit from supportive services. Navigator activities are guided by frequent distress assessments, which help to identify patient concerns across multiple domains, triage patients to appropriate resources, and ultimately overcome barriers to health care. In this article, we describe the PCCP's development, infrastructure, selection and training of lay navigators, and program operations.
Konovalov, A A
The comparative analysis was implemented concerning versions of architecture of segment of unified public information system of health care within the framework of the regional program of modernization of Nizhniy Novgorod health care system. The author proposed means of increasing effectiveness of public investments on the basis of analysis of aggregate value of ownership of information system. The evaluation is given concerning running up to target program indicators and dynamics of basic indicators of informatization of institutions of oblast health care system.
Jennings, Lee A; Tan, Zaldy; Wenger, Neil S; Cook, Erin A; Han, Weijuan; McCreath, Heather E; Serrano, Katherine S; Roth, Carol P; Reuben, David B
Multiple studies have shown that quality of care for dementia in primary care is poor, with physician adherence to dementia quality indicators (QIs) ranging from 18% to 42%. In response, the University of California at Los Angeles (UCLA) Health System created the UCLA Alzheimer's and Dementia Care (ADC) Program, a quality improvement program that uses a comanagement model with nurse practitioner dementia care managers (DCM) working with primary care physicians and community-based organizations to provide comprehensive dementia care. The objective was to measure the quality of dementia care that nurse practitioner DCMs provide using the Assessing Care of Vulnerable Elders (ACOVE-3) and Physician Consortium for Performance Improvement QIs. Participants included 797 community-dwelling adults with dementia referred to the UCLA ADC program over a 2-year period. UCLA is an urban academic medical center with primarily fee-for-service reimbursement. The percentage of recommended care received for 17 dementia QIs was measured. The primary outcome was aggregate quality of care for the UCLA ADC cohort, calculated as the total number of recommended care processes received divided by the total number of eligible quality indicators. Secondary outcomes included aggregate quality of care in three domains of dementia care: assessment and screening (7 QIs), treatment (6 QIs), and counseling (4 QIs). QIs were abstracted from DCM notes over a 3-month period from date of initial assessment. Individuals were eligible for 9,895 QIs, of which 92% were passed. Overall pass rates of DCMs were similar (90-96%). All counseling and assessment QIs had pass rates greater than 80%, with most exceeding 90%. Wider variation in adherence was found among QIs addressing treatments for dementia, which patient-specific criteria triggered, ranging from 27% for discontinuation of medications associated with mental status changes to 86% for discussion about acetylcholinesterase inhibitors. Comprehensive
... HUMAN SERVICES Administration on Aging Funding Opportunity: Affordable Care Act Medicare Beneficiary...: Availability of funding opportunity announcement. Funding Opportunity Title/Program Name: Affordable Care Act... Protection and Affordable Care Act of 2010 (Affordable Care Act). Catalog of Federal Domestic......
Betts, Helen J; Wright, Graham
As nurses around the world prepare to celebrate the centenary of the death of Florence Nightingale in 2010 this paper reviews her work on using information, especially statistics, to analyze and manage patient care and links that to current developments in informatics. It then examines assistive technologies and how they may impact on nursing practice in the future and links these developments to the writings of Florence Nightingale. The paper concludes by suggesting that in progressing towards sustainable and ubiquitous healthcare informatics we need to study history in order to learn from the lessons of Florence Nightingale and other healthcare pioneers.
Kho, David Y; Bluth, Edward I; Meenan, Christopher; Nagy, Paul G
The Certification for Imaging Informatics Professionals (CIIP) program is sponsored by the Society of Imaging Informatics in Medicine and the American Registry of Radiologic Technologists through the American Board of Imaging Informatics. In 2005, a survey was conducted of radiologists, technologists, information technology specialists, corporate information officers, and radiology administrators to identify the competencies and skill set that would define a successful PACS administrator. The CIIP examination was created in 2007 in response to the need for an objective way to test for such competencies, and there have been 767 professionals who have been certified through this program to date. The validity of the psychometric integrity of the examination has been previously established. In order to further understand the impact and future direction of the CIIP certification on diplomats, a survey was conducted in 2010. This paper will discuss the results of the survey.
...-9957-CN; 9964-CN] RIN 0938-AR82; RIN 0938-AR74 Patient Protection and Affordable Care Act; Program... Affordable Care Act; Program Integrity: Exchange, Premium Stabilization Programs, and Market Standards... and Affordable Care Act; Program Integrity: Exchange, Premium Stabilization Programs, and...
of the available new patient education materials. We will conduct an inservice to review the contents of the new Education Core file cabinet with all...breast cancer and to conduct inservices of nurses about programs, methods, post operative instructions and care related issues Our primary goal for year...programs and services for the benefit of the patient. Our Continuous Quality Improvement, Informatics and Education Cores are working together to help
Detmer, D E
Substantial global and national commitment will be required for current healthcare systems and health professional practices to become learning care systems utilizing information and communications technology (ICT) empowered by informatics. To engage this multifaceted challenge, a vision is required that shifts the emphasis from silos of activities toward integrated systems. Successful systems will include a set of essential elements, e.g., a sufficient ICT infrastructure, evolving health care processes based on evidence and harmonized to local cultures, a fresh view toward educational preparation, sound and sustained policy support, and ongoing applied research and development. Increasingly, leaders are aware that ICT empowered by informatics must be an integral part of their national and regional visions. This paper sketches out the elements of what is needed in terms of objectives and some steps toward achieving them. It summarizes some of the progress that has been made to date by the American and International Medical Informatics Associations working separately as well as collaborating to conceptualize informatics capacity building in order to bring this vision to reality in low resource nations in particular.
Angus, D E; Lay, C M
Canada's provincial health care systems have been experiencing significant changes, mostly through horizontal integration achieved by merging hospitals, and, in a few cases, through vertical integration of public health, long term care, home care and hospital services. The government motivation for forcing these changes seems to have been primarily financial. In a few cases, the integration seems to have resulted in a stable and successful outcome, but, in most others, there has been destabilization, and in some, there has been chaos. The question posed in this research was how the five accredited Canadian graduate programs in health care management were responding to these changes. Two of the programs have recently made major changes in structure and/or delivery processes, following careful examination of their perceived environments. One has rationalized by subdividing courses. Another is repatriating courses from the business school in order to achieve more health-related content. Four of the five programs have added a number of courses in the last few years, or plan to do so in the next year or two, either because of accreditation criteria or student or faculty interest. The program directors viewed the educational requirements for clinicians and non-clinicians as being identical. In spite of the major structural changes, and the resulting destabilization of the health care organizations (and even governments), none of the programs emphasized the changes as factors in their plans for program changes. They expressed some concern about the possibility of fads as opposed to significant changes. It may be that these changes are dealt with in the content of individual courses. This aspect was not examined by the survey nor by interviews with the directors. Each of the programs has emphasized its own niche, with no consensus about changes required.
Narration is central, even crucial, when it comes to embracing the whole individual, continuity of care, and responsible (ethical) handling of the technological construction of the self that takes place in health informatics. This paper will deal with the role of narratives in the construction of health informatics platforms and how different voices should have space for speech on these platforms. Theoretically the paper takes an outset in the actant model for narratives by the French-Lithuanian theorist of linguistics and literature A.-J. Greimas and post-phenomenological readings of human-technology interactions. The main assumption is that certain interactions and voices are absent from the construction of health informatics platforms, because regarded as outside the text of computational and medical practice and expertise. This has implications for what concerns meaning and understanding regarding both the actual users (physicians and medical staff) and excluded users (patients and citizens).
Acharya, U; Dua, Prerna
The book is a unique effort to represent a variety of techniques designed to represent, enhance, and empower multi-disciplinary and multi-institutional machine learning research in healthcare informatics. The book provides a unique compendium of current and emerging machine learning paradigms for healthcare informatics and reflects the diversity, complexity and the depth and breath of this multi-disciplinary area. The integrated, panoramic view of data and machine learning techniques can provide an opportunity for novel clinical insights and discoveries.
Yu, Ying; Fu, Xiaobing
Chronic wounds in China are an important issue. However, wound care knowledge and the skill of health care professionals varies among hospitals and cities. The Chinese Tissue Repair Society (CTRS) has developed a 3-year training program in wound care in China that is sponsored by the World Diabetes Foundation and the Coloplast Access to Healthcare foundation. The project focuses on training physicians and nurses in wound care for patients with diabetic mellitus and other chronic skin wounds. In the past 2 years, 1618 health care professionals, including 915 physicians and 703 nurses, have been trained. Participants are from more than 200 hospitals in 21 provinces. About 1200 patients per month, on average, have benefited from this project. In total, 13 hospitals have become training bases to continue the education program. The aim of the program is to help Chinese medical professionals efficiently manage chronic wounds, thereby shortening the wound healing time, reducing the amputation rate and treatment costs, and improving quality of life.
Keselman, Alla; Logan, Robert; Smith, Catherine Arnott; Leroy, Gondy; Zeng-Treitler, Qing
As the emphasis on individuals' active partnership in health care grows, so does the public's need for effective, comprehensible consumer health resources. Consumer health informatics has the potential to provide frameworks and strategies for designing effective health communication tools that empower users and improve their health decisions. This article presents an overview of the consumer health informatics field, discusses promising approaches to supporting health communication, and identifies challenges plus direction for future research and development. The authors' recommendations emphasize the need for drawing upon communication and social science theories of information behavior, reaching out to consumers via a range of traditional and novel formats, gaining better understanding of the public's health information needs, and developing informatics solutions for tailoring resources to users' needs and competencies. This article was written as a scholarly outreach and leadership project by members of the American Medical Informatics Association's Consumer Health Informatics Working Group.
Although object technology is just starting to make inroads in programming for health care applications, some observers predict it will drive information systems into the next century and beyond. Objects technology could play a major role in quicker development of the computer-based patient record and in easing the creation of links between systems.
... systems for child care quality improvement. This proposed rule is driven by the same priorities and vision... into better alignment with the current knowledge in the field, result in a more comprehensive vision of... administration of the program. These proposed changes represent minimum, common-sense standards for the...
Silberstein, Dalia; Litmanovitz, Ita
During hospitalization in the neonatal intensive care unit (NICU), the brain of the preterm infant undergoes a particularly vulnerable and sensitive period of development. Brain development might be negatively influenced by direct injury as well as by complications of prematurity. Over the past few years, stress has come to be increasingly recognized as a potential risk factor. The NICU environment contains numerous stress factors due to maternal deprivation and over-stimulation, such as light, sound and pain, which conflict with the brain's developmental requirements. Developmental care is a caregiving approach that addresses the early developmental needs of the preterm infant as an integral component of quality neonatal care. NIDCAP (Newborn Individualized Developmental Care and Assessment Program) is a comprehensive program that aims to reduce environmental stress, to support the infant's neuro-behavioral maturation and organization, and to promote early parent-infant relationships. The implementation of developmental care based on NIDCAP principles is a gradual, in-depth systems change process, which affects all aspects of care in the NICU. This review describes the theoretical basis of the NIDCAP approach, summarizes the scientific evidence and addresses some of the implications of the transition from a traditional to a developmental care NICU.
Oberlies, Amanda Stefancyk
The American Organization of Nurse Executives conducted an evaluation of the hospitals participating in the Care Innovation and Transformation (CIT) program. A total of 24 hospitals participated in the 2-year CIT program from 2012 to 2013. Reported outcomes include increased patient satisfaction, decreased falls, and reductions in nurse turnover and overtime. Nurses reported statistically significant improvements in 4 domains of the principles and elements of a healthful practice environment developed by the Nursing Organizations Alliance.
... Participating in ACOs c. Antitrust Policy Statement d. Coordinating the Shared Savings Program Application With...) Identification of Primary Care Services Rendered in FQHCs and RHCs (2) Identification of the Type of Practitioner... Insurance Program CMP Civil Monetary Penalties CMS Centers for Medicare & Medicaid Services CNM...
Full Text Available Vaccine informatics is an emerging research area that focuses on development and applications of bioinformatics methods that can be used to facilitate every aspect of the preclinical, clinical, and postlicensure vaccine enterprises. Many immunoinformatics algorithms and resources have been developed to predict T- and B-cell immune epitopes for epitope vaccine development and protective immunity analysis. Vaccine protein candidates are predictable in silico from genome sequences using reverse vaccinology. Systematic transcriptomics and proteomics gene expression analyses facilitate rational vaccine design and identification of gene responses that are correlates of protection in vivo. Mathematical simulations have been used to model host-pathogen interactions and improve vaccine production and vaccination protocols. Computational methods have also been used for development of immunization registries or immunization information systems, assessment of vaccine safety and efficacy, and immunization modeling. Computational literature mining and databases effectively process, mine, and store large amounts of vaccine literature and data. Vaccine Ontology (VO has been initiated to integrate various vaccine data and support automated reasoning.
E.M. van Mulligen (Erik); M. Cases (Montserrat); K.M. Hettne (Kristina); E. Molero (Eva); M. Weeber (Marc); K.A. Robertson (Kevin); B. Oliva (Baldomero); G. de la Calle (Guillermo); V. Maojo (Victor)
textabstractObjective: The European INFOBIOMED Network of Excellence1recognized that a successful education program in biomedical informatics should include not only traditional teaching activities in the basic sciences but also the development of skills for working in multidisciplinary teams. Desig
Sergienko, Ivan V
This work is devoted to the late Ukrainian computer scientist V. M. Glushkov on the 90th anniversary of his birthday. Dr. Glushkov is known for his contribution to the world computer science and technology, and this volume analyzes the ideas and paths of development of informatics formulated by him, and demonstrates their important role in constructing computer technologies of basic research in the fields of applied mathematics, theories of computer programming, and computing systems. A significant portion of the monograph is devoted to the elucidation of new results obtained in the field of mathematical modeling of complicated processes, creation of new methods for solving and investigating optimization problems in different statements, and development of computer technologies for investigations in the field of economy, biology, medicine, and information security in systems. The monograph will be of particular interest to informatics specialists and experts using methods of informatics and computer...
Hua, Ertian; Lin, Yun; Liu, Xiaozhu
Computer Informatics Cybernetics and Applications offers 91 papers chosen for publication from among 184 papers accepted for presentation to the International Conference on Computer, Informatics, Cybernetics and Applications 2011 (CICA 2011), held in Hangzhou, China, September 13-16, 2011. The CICA 2011 conference provided a forum for engineers and scientists in academia, industry, and government to address the most innovative research and development including technical challenges and social, legal, political, and economic issues, and to present and discuss their ideas, results, work in progress and experience on all aspects of Computer, Informatics, Cybernetics and Applications. Reflecting the broad scope of the conference, the contents are organized in these topical categories: Communication Technologies and Applications Intelligence and Biometrics Technologies Networks Systems and Web Technologies Data Modeling and Programming Languages Digital Image Processing Optimization and Scheduling Education and In...
Full Text Available Abstract Background We have previously demonstrated that routinely collected primary care data can be used to identify potential participants for trials in depression . Here we demonstrate how patients with psychotic disorders can be identified from primary care records for potential inclusion in a cohort study. We discuss the strengths and limitations of this approach; assess its potential value and report challenges encountered. Methods We designed an algorithm with which we searched for patients with a lifetime diagnosis of psychotic disorders within the Secure Anonymised Information Linkage (SAIL database of routinely collected health data. The algorithm was validated against the "gold standard" of a well established operational criteria checklist for psychotic and affective illness (OPCRIT. Case notes of 100 patients from a community mental health team (CMHT in Swansea were studied of whom 80 had matched GP records. Results The algorithm had favourable test characteristics, with a very good ability to detect patients with psychotic disorders (sensitivity > 0.7 and an excellent ability not to falsely identify patients with psychotic disorders (specificity > 0.9. Conclusions With certain limitations our algorithm can be used to search the general practice data and reliably identify patients with psychotic disorders. This may be useful in identifying candidates for potential inclusion in cohort studies.
Child Trends, 2010
This paper presents a profile of Tennessee's Star-Quality Child Care Program prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…
King, Andrew J; Fisher, Arielle M; Becich, Michael J; Boone, David N
The University of Pittsburgh's Department of Biomedical Informatics and Division of Pathology Informatics created a Science, Technology, Engineering, and Mathematics (STEM) pipeline in 2011 dedicated to providing cutting-edge informatics research and career preparatory experiences to a diverse group of highly motivated high-school students. In this third editorial installment describing the program, we provide a brief overview of the pipeline, report on achievements of the past scholars, and present results from self-reported assessments by the 2015 cohort of scholars. The pipeline continues to expand with the 2015 addition of the innovation internship, and the introduction of a program in 2016 aimed at offering first-time research experiences to undergraduates who are underrepresented in pathology and biomedical informatics. Achievements of program scholars include authorship of journal articles, symposium and summit presentations, and attendance at top 25 universities. All of our alumni matriculated into higher education and 90% remain in STEM majors. The 2015 high-school program had ten participating scholars who self-reported gains in confidence in their research abilities and understanding of what it means to be a scientist.
Patel, Vimla L; Yoskowitz, Nicole A; Arocha, Jose F; Shortliffe, Edward H
Theoretical and methodological advances in the cognitive and learning sciences can greatly inform curriculum and instruction in biomedicine and also educational programs in biomedical informatics. It does so by addressing issues such as the processes related to comprehension of medical information, clinical problem-solving and decision-making, and the role of technology. This paper reviews these theories and methods from the cognitive and learning sciences and their role in addressing current and future needs in designing curricula, largely using illustrative examples drawn from medical education. The lessons of this past work are also applicable, however, to biomedical and health professional curricula in general, and to biomedical informatics training, in particular. We summarize empirical studies conducted over two decades on the role of memory, knowledge organization and reasoning as well as studies of problem-solving and decision-making in medical areas that inform curricular design. The results of this research contribute to the design of more informed curricula based on empirical findings about how people learn and think, and more specifically, how expertise is developed. Similarly, the study of practice can also help to shape theories of human performance, technology-based learning, and scientific and professional collaboration that extend beyond the domain of medicine. Just as biomedical science has revolutionized health care practice, research in the cognitive and learning sciences provides a scientific foundation for education in biomedicine, the health professions, and biomedical informatics.
Choi, Jeungok; Zucker, Donna M
This study examined the informatics competencies of doctor of nursing practice (DNP) students and whether these competencies differed between DNP students in the post-baccalaureate (BS) and post-master's (MS) tracks. Self-reported informatics competencies were collected from 132 DNP students (68 post-BS and 64 post-MS students) in their first year in the program (2007 to 2010). Students were assessed in 18 areas of 3 competency categories: computer skills, informatics knowledge, and informatics skills. Post-BS students were competent in 4 areas (computer skills in communication, systems, documentation, and informatics knowledge about impact of information management), whereas post-MS students were competent in only 1 area (computer skills in communication). Students in both tracks reported computer skills in decision support as their least competent area. Overall, post-BS students reported slightly higher than or similar competency scores as post-MS students, but scores were statistically significant in only 3 of 18 areas. The assessment indicated that knowledge and skills on informatics competencies need to be improved, especially in computer skills for data access and use of decision support systems. Strategies are suggested to integrate competencies into existing informatics course and DNP curricula. Further studies are recommended using an objective measure of informatics competencies.
Ana Railka de Souza Oliveira
Full Text Available The purpose of this study was to evaluate the patient with a stroke in home treatment, investigating physical capacity, mental status and anthropometric analysis. This was a cross-sectional study conducted in Fortaleza/CE, from January to April of 2010. Sixty-one individuals monitored by a home care program of three tertiary hospitals were investigated, through interviews and the application of scales. The majority of individuals encountered were female (59%, elderly, bedridden, with a low educational level, a history of other stroke, a high degree of dependence for basic (73.8% and instrumental (80.3 % activities of daily living, and a low cognitive level (95.1%. Individuals also presented with tracheostomy, gastric feeding and urinary catheter, difficulty hearing, speaking, chewing, swallowing, and those making daily use of various medications. It was concluded that home care by nurses is an alternative for care of those individuals with a stroke.
Ana Railka de Souza Oliveira
Full Text Available The purpose of this study was to evaluate the patient with a stroke in home treatment, investigating physical capacity, mental status and anthropometric analysis. This was a cross-sectional study conducted in Fortaleza/CE, from January to April of 2010. Sixty-one individuals monitored by a home care program of three tertiary hospitals were investigated, through interviews and the application of scales. The majority of individuals encountered were female (59%, elderly, bedridden, with a low educational level, a history of other stroke, a high degree of dependence for basic (73.8% and instrumental (80.3 % activities of daily living, and a low cognitive level (95.1%. Individuals also presented with tracheostomy, gastric feeding and urinary catheter, difficulty hearing, speaking, chewing, swallowing, and those making daily use of various medications. It was concluded that home care by nurses is an alternative for care of those individuals with a stroke.
van Bemmel, J H
OBJECTIVE. Reviewing the onset and the rapid changes to make realistic predictions on the future of medical informatics. METHODS. Pointing to the contributions of the early pioneers, who had their roots in other disciplines and by illustrating that from the onset an interdisciplinary approach was characteristic for our field. RESULTS. Some of the reasons for the changes in medical informatics are that nobody was able to predict the advent of the personal computer in the 1970s, the world-wide web in 1991, and the public start of the Internet in 1992, but foremost that nobody expected that it was not primarily the hardware or the software, but human factors that would be crucial for successful applications of computers in health care. In the past sometimes unrealistic expectations were held, such as on the impact of medical decision-support systems, or on the overly optimistic contributions of electronic health records. Although the technology is widely available, some applications appear to be far more complex than expected. Health care processes can seldom be fully standardized. Humans enter at least in two very different roles in the loop of information processing: as subjects conducting care - the clinicians - and as subjects that are the objects of care - the patients. CONCLUSIONS. Medical informatics lacks a specific methodology; methods are borrowed from adjacent disciplines such as physics, mathematics and, of course, computer science. Human factors play a major role in applying computers in health care. Everyone pursuing a career in biomedical informatics needs to be very aware of this. It is to be expected that the quality of health care will increasingly be assessed by computer systems to fulfill the requirements of medical evidence.
Were, Martin C; Siika, Abraham; Ayuo, Paul O; Atwoli, Lukoye; Esamai, Fabian
Current approaches for capacity building in Health Informatics (HI) in developing countries mostly focus on training, and often rely on support from foreign entities. In this paper, we describe a comprehensive and multidimensional capacity-building framework by Lansang & Dennis, and its application for HI capacity building as implemented in a higher-education institution in Kenya. This framework incorporates training, learning-by-doing, partnerships, and centers of excellence. At Moi University (Kenya), the training dimensions include an accredited Masters in HI Program, PhD in HI, and HI short courses. Learning-by-doing occurs through work within MOH facilities at the AMPATH care and treatment program serving 3 million people. Moi University has formed strategic HI partnerships with Regenstrief Institute, Inc. (USA), University of Bergen (Norway), and Makerere University (Uganda), among others. The University has also created an Institute of Biomedical Informatics to serve as an HI Center of Excellence in the region. This Institute has divisions in Training, Research, Service and Administration. The HI capacity-building approach by Moi provides a model for adoption by other institutions in resource-limited settings.
Full Text Available Introduction & Background: Inclusion of informatics issues in radiology practice and education is no longer an interest or a research topic. Information technol-ogy has affected many aspects of radiology practice much further than technologic advancement of new imaging modalities. The aim of this article is to briefly review the role of computers and IT in mod-ern radiology. Image: Acquisition (CR / DR / DICOM, Storage, Processing (3D reconstruction, Edge enhancement, Contrast change, etc, and Perception of image for computer aided detection are all real example of IT applications affecting diagnostic imaging. Management: Radiology information systems used for multiple purposes (Resource management, Financial management, Report management, Workflow man-agement are professional and specialized manage-ment information systems used in imaging depart-ment. Decision Making: Image understanding, Reference databases, Decision support systems may be consid-ered as examples of how IT may improve the decision makings of a radiologist. Education: E-learning in radiology has many advan-tages to traditional education including reproducibil-ity, use of multimedia technology, distant education, multi-user or even multi-center educations are among them. Digital teaching files can easily replace old film files especially considering the wide avail-ability of originally digital images. Communication: Internet and teleradiology have broken the boundaries of place and time. Consulta-tions, grouped radiology services, overseas practice and countrywide imaging archives are all possible using internet and HTML technology. Wireless tech-nology is growingly included in intra-departmental and intra-hospital radiological image and information transfer shows promising role in emergency radiol-ogy. Reporting: Speech recognition, Structured reporting, Multi-media reporting are example of electronic re-porting depicting emerging change in radiology re-ports that were less
The concept of materials informatics is presented and expounded for the first time. Main tasks and research areas of materials informatics are listed and stated. The significance of developing materials informatics is discussed. Suggestions for developing this new discipline are put forward.
Full Text Available A characteristic of the actual informatics’ context is the interference of the technologies, which assumes that for creating an informatics product, is necessary to use integrate many technologies. This thing is also used for database systems which had integrated, in the past few years, almost everything is new in informatics technology. The idea is that when using database management systems - DBMS the user can benefit all the necessary interfaces and instruments for developing an application with databases from the very beginning to the end, no matter the type of application and the work environment. For example, if the database application needs any Internet facilities these could be appealed from the products that the DBMS is working with offers. The concept of the interference of informatics technologies has many advantages, which all contribute to increasing the efficiency of the activities that develop and maintain complex databases applications.
Kalhan, S C; Wilson-Costello, D
Contemporary clinical practice for the care of the prematurely born babies has markedly improved their rates of survival so that most of these babies are expected to grow up to live a healthy functional life. Since the clinical follow-up is of short duration (years), only limited data are available to relate non-communicable diseases in adult life to events and interventions in the neonatal period. The major events that could have a programming effect include: (1) intrauterine growth restriction; (2) interruption of pregnancy with change in redox and reactive oxygen species (ROS) injury; (3) nutritional and pharmacological protocols for clinical care; and (4) nutritional care in the first 2 years resulting in accelerated weight gain. The available data are discussed in the context of perturbations in one carbon (methyl transfer) metabolism and its possible programming effects. Although direct evidence for genomic methylation is not available, clinical and experimental data on impact of redox and ROS, of low protein intake, excess methionine load and vitamin A, on methyl transfers are reviewed. The consequences of antenatal and postnatal administration of glucocorticoids are presented. Analysis of the correlates of insulin sensitivity at older age, suggests that premature birth is the major contributor, and is compounded by gain in weight during infancy. We speculate that premature interruption of pregnancy and neonatal interventions by affecting one carbon metabolism may cause programming effects on the immature baby. These can be additive to the effects of intrauterine environment (growth restriction) and are compounded by accelerated growth in early infancy.
Ely, Andrea C.; Banitt, Angela; Befort, Christie; Hou, Qing; Rhode, Paula C.; Grund, Chrysanne; Greiner, Allen; Jeffries, Shawn; Ellerbeck, Edward
Context: Obesity is a chronic disease of epidemic proportions in the United States. Primary care providers are critical to timely diagnosis and treatment of obesity, and need better tools to deliver effective obesity care. Purpose: To conduct a pilot randomized trial of a chronic care model (CCM) program for obesity care in rural Kansas primary…
Bronzino, Joseph D
Known as the bible of biomedical engineering, The Biomedical Engineering Handbook, Fourth Edition, sets the standard against which all other references of this nature are measured. As such, it has served as a major resource for both skilled professionals and novices to biomedical engineering.Biomedical Signals, Imaging, and Informatics, the third volume of the handbook, presents material from respected scientists with diverse backgrounds in biosignal processing, medical imaging, infrared imaging, and medical informatics.More than three dozen specific topics are examined, including biomedical s
David S McClintock
Full Text Available Background: In 2007, our healthcare system established a clinical fellowship program in Pathology Informatics. In 2010 a core didactic course was implemented to supplement the fellowship research and operational rotations. In 2011, the course was enhanced by a formal, structured core curriculum and reading list. We present and discuss our rationale and development process for the Core Curriculum and the role it plays in our Pathology Informatics Fellowship Training Program. Materials and Methods: The Core Curriculum for Pathology Informatics was developed, and is maintained, through the combined efforts of our Pathology Informatics Fellows and Faculty. The curriculum was created with a three-tiered structure, consisting of divisions, topics, and subtopics. Primary (required and suggested readings were selected for each subtopic in the curriculum and incorporated into a curated reading list, which is reviewed and maintained on a regular basis. Results: Our Core Curriculum is composed of four major divisions, 22 topics, and 92 subtopics that cover the wide breadth of Pathology Informatics. The four major divisions include: (1 Information Fundamentals, (2 Information Systems, (3 Workflow and Process, and (4 Governance and Management. A detailed, comprehensive reading list for the curriculum is presented in the Appendix to the manuscript and contains 570 total readings (current as of March 2012. Discussion: The adoption of a formal, core curriculum in a Pathology Informatics fellowship has significant impacts on both fellowship training and the general field of Pathology Informatics itself. For a fellowship, a core curriculum defines a basic, common scope of knowledge that the fellowship expects all of its graduates will know, while at the same time enhancing and broadening the traditional fellowship experience of research and operational rotations. For the field of Pathology Informatics itself, a core curriculum defines to the outside world
California Childcare Health Program, 2011
This "Integrated Pest Management Toolkit for Early Care and Education Programs" presents practical information about using integrated pest management (IPM) to prevent and manage pest problems in early care and education programs. This curriculum will help people in early care and education programs learn how to keep pests out of early…
Sirintrapun, S Joseph; Zehir, Ahmet; Syed, Aijazuddin; Gao, JianJiong; Schultz, Nikolaus; Cheng, Donavan T
Translational bioinformatics and clinical research (biomedical) informatics are the primary domains related to informatics activities that support translational research. Translational bioinformatics focuses on computational techniques in genetics, molecular biology, and systems biology. Clinical research (biomedical) informatics involves the use of informatics in discovery and management of new knowledge relating to health and disease. This article details 3 projects that are hybrid applications of translational bioinformatics and clinical research (biomedical) informatics: The Cancer Genome Atlas, the cBioPortal for Cancer Genomics, and the Memorial Sloan Kettering Cancer Center clinical variants and results database, all designed to facilitate insights into cancer biology and clinical/therapeutic correlations.
Walker, Judi; Cullen, Marianne; Chambers, Helen; Mitchell, Eleanor; Steers, Nicole; Khalil, Hanan
Measuring the prevalence of wounds within health care systems is a challenging and complex undertaking. This is often compounded by the clinicians' training, the availability of the required data to collect, incomplete documentation and lack of reporting of this type of data across the various health care settings. To date, there is little published data on wound prevalence across regions or states. This study aims to identify the number and types of wounds treated in the Gippsland area using the Mobile Wound Care (MWC™) program. The MWC program has enabled clinicians in Gippsland to collect data on wounds managed by district nurses from four health services. The main outcomes measured were patient characteristics, wound characteristics and treatment characteristics of wounds in Gippsland. These data create several clinical and research opportunities. The identification of predominant wound aetiologies in Gippsland provides a basis on which to determine a regional wound prospective and the impact of the regional epidemiology. Training that incorporates best practice guidelines can be tailored to the most prevalent wound types. Clinical pathways that encompass the Australian and New Zealand clinical practice guidelines for the management of venous leg ulcers can be introduced and the clinical and economical outcomes can be quantitatively measured. The MWC allows healing times (days) to be benchmarked both regionally and against established literature, for example, venous leg ulcers.
This Brief highlights Informatics and related techniques to Computer Science Professionals, Engineers, Medical Doctors, Bioinformatics researchers and other interdisciplinary researchers. Chapters include the Bioinformatics of Diabetes and several computational algorithms and statistical analysis approach to effectively study the disorders and possible causes along with medical applications.
Ravi, Daniele; Wong, Charence; Deligianni, Fani; Berthelot, Melissa; Andreu-Perez, Javier; Lo, Benny; Yang, Guang-Zhong
With a massive influx of multimodality data, the role of data analytics in health informatics has grown rapidly in the last decade. This has also prompted increasing interests in the generation of analytical, data driven models based on machine learning in health informatics. Deep learning, a technique with its foundation in artificial neural networks, is emerging in recent years as a powerful tool for machine learning, promising to reshape the future of artificial intelligence. Rapid improvements in computational power, fast data storage, and parallelization have also contributed to the rapid uptake of the technology in addition to its predictive power and ability to generate automatically optimized high-level features and semantic interpretation from the input data. This article presents a comprehensive up-to-date review of research employing deep learning in health informatics, providing a critical analysis of the relative merit, and potential pitfalls of the technique as well as its future outlook. The paper mainly focuses on key applications of deep learning in the fields of translational bioinformatics, medical imaging, pervasive sensing, medical informatics, and public health.
Hematology Hospice Internal Medicine Informatics Medical Genetics Long-Term Care Neonatology Medical/ Surgical Nephrology Neonatal...Internal Medicine Informatics Medical Genetics Long-Term Care Neonatology Medical/ Surgical Nephrology Neonatal Neurology Neurology...Hematology Hospice Internal Medicine Informatics Medical Genetics Long-Term Care Neonatology Medical/ Surgical Nephrology Neonatal
Heermann, Judith A.; Warren, Judith J.
Challenged with the need to provide graduate education in nursing informatics across the state of Nebraska, an innovative curriculum was developed. This curriculum is integrated with other system-focused specialties (community health nursing and nursing administration) to form a Health Systems Nurse Specialist (HSNS) Program. The delivery of this curriculum was designed to be as independent of time and place as possible. Nurses especially in rural areas, have embraced this program as they can...
Savel, Thomas G; Foldy, Seth
Public health surveillance has benefitted from, and has often pioneered, informatics analyses and solutions. However, the field of informatics also serves other facets of public health including emergency response, environmental health, nursing, and administration. Public health informatics has been defined as the systematic application of information and computer science and technology to public health practice, research, and learning. It is an interdisciplinary profession that applies mathematics, engineering, information science, and related social sciences (e.g., decision analysis) to important public health problems and processes. Public health informatics is a subdomain of the larger field known as biomedical or health informatics. Health informatics is not synonymous with the term health information technology (IT). Although the concept of health IT encompasses the use of technology in the field of health care, one can think of health informatics as defining the science, the how and why, behind health IT. For example, health IT professionals should be able to resolve infrastructure problems with a network connection, whereas trained public health informaticians should be able to support public health decisions by facilitating the availability of timely, relevant, and high-quality information. In other words, they should always be able to provide advice on methods for achieving a public health goal faster, better, or at a lower cost by leveraging computer science, information science, or technology.
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Akhilesh S Pathipati
Full Text Available Introduction: Teledermatology has proven to be an effective means of providing dermatologic care. The existing research has primarily evaluated its usefulness in a consultative model. Few academic centers have evaluated a patient-initiated model, and direct-to-consumer services remain the subject of controversy. Stanford Health Care recently launched a direct-care, patient-initiated teledermatology pilot program. This article evaluates the viability and patient satisfaction with this service. Materials and Methods: During the pilot period, patients were able to seek remote dermatologic care using an eVisit tool in their MyHealth account. Patients initiated the consultation, answered questions regarding their complaint, and uploaded a picture if relevant. A Stanford dermatologist reviewed each eVisit and responded with an assessment and plan. The dermatologist noted whether they were able to make a diagnosis and their level of confidence in it. After the study, 10 patients participated in a focus group to provide feedback on the service. Results: In all, 38 patients sought care during the pilot period. A dermatologist was able to make a diagnosis in 36 of 38 (95% cases, with an average confidence level of 7.9 of 10. The average time to consultation was 0.8 days. Patients indicated high levels of satisfaction with the service although they had suggestions for improvement. Discussion: Patients provided clinically useful images and information in a direct-care teledermatology model. Such services allow dermatology providers to increase access while maintaining high-quality care in an academic medical center. Further research is needed on standalone services that cannot integrate encounters with the patient’s existing medical record.
Khan-Mayberry, Noreen; Bassett, Stephanie
NASA has a rich history of scientific research that has been conducted throughout our numerous manned spaceflight programs. This scientific research has included animal test subjects participating in various spaceflight missions, including most recently, Space Shuttle mission STS-131. The Animal Care Program at Johnson Space Center (JSC) in Houston, Texas is multi-faceted and unique in scope compared to other centers within the agency. The animal care program at JSC has evolved from strictly research to include a Longhorn facility and the Houston Zoo's Attwater Prairie Chicken refuge, which is used to help repopulate this endangered species. JSC is home to more than 300 species of animals including home of hundreds of white-tailed deer that roam freely throughout the center which pose unique issues in regards to population control and safety of NASA workers, visitors and tourists. We will give a broad overview of our day to day operations, animal research, community outreach and protection of animals at NASA Johnson Space Center.
Hill, C J; Sorenson, H W; Mink, J R
Five types of space maintainers were placed in 196 children participating in an extensive dental care program during a four-year study. Children with space maintainers were examined at six-month intervals. During the study, some sort of difficulty was encountered with 43% of the appliances inserted. The most common problem encountered was lost or missing appliances. Sixteen appliances had broken arch wires or loop wires; only ten broken bands were noted. Anther problem was distortion of arch wires. Suggestions are made for possible modifications in the space maintainers to reduce the incidence of problems.
王孝宁; 张合华; 汪洋; 杨佐森; 赵玉虹
基层医疗卫生机构管理信息系统建设是卫生信息化的重要内容。本文基于实地调研、访谈、问卷等方法，详细介绍了辽宁省基层卫生信息化状况，为基层医疗卫生机构管理信息系统建设方案的制定和项目实施提供参考。%Management information system of primary health care institutions is one of the most important parts of health informatization. Based on methods of field research, interview, and questionnaire ,etc. this article introduced the current situation of primary health informatization in Liaoning province, which may provides references for the plan making and program implementation of management information system for primary health care institutions.
Steele, Rose; Davies, Betty; Collins, John B; Cook, Karen
A project was completed in 1999 to evaluate the Canuck Place children's hospice program. This article reports only on the end-of-life care component. Results are provided from mail-out surveys with families who required end-of-life care and are supplemented by qualitative data which were collected from interviews with individuals prior to the survey. Eighteen families completed face-to-face interviews and another 70 families completed the mail-out questionnaire developed from the initial interviews. A total of 39 parents responded to the survey section about end-of-life care services. Results indicated that parents were reasonably comfortable discussing death with staff; they generally felt well prepared for their child's death because of the staff; the death of another child had a significant effect on families; parents' wishes at the time of their child's death were very supported by staff; and families were well supported by staff at the time of a child's death. Implications for practice and suggestions for future research are discussed.
Gassert, C. A.; Mills, M. E.; Heller, B R
A prototype program of doctoral study has been developed at the University of Maryland School of Nursing to prepare students with nursing expertise in the conceptualization and research of computer based information systems in hospitals, industry and other health care organizations. The graduate will be prepared to design effective nursing information systems; create innovative information technology; conduct research regarding integration of technology with nursing practice, administration, ...
Full Text Available Objective: To develop an in-depth understanding of a shared care model from primary mental health and nutrition care practitioners with a focus on program goals, strengths, challenges and target population benefits. Design: Qualitative method of focus groups. Setting/Participants: The study involved fifty-three practitioners from the Hamilton Health Service Organization Mental Health and Nutrition Program located in Hamilton, Ontario, Canada. Method: Six focus groups were conducted to obtain the perspective of practitioners belonging to various disciplines or health care teams. A qualitative approach using both an editing and template organization styles was taken followed by a basic content analysis. Main findings: Themes revealed accessibility, interdisciplinary care, and complex care as the main goals of the program. Major program strengths included flexibility, communication/collaboration, educational opportunities, access to patient information, continuity of care, and maintenance of practitioner and patient satisfaction. Shared care was described as highly dependent on communication style, skill and expertise, availability, and attitudes toward shared care. Time constraint with respect to collaboration was noted as the main challenge. Conclusion: Despite some challenges and variability among practices, the program was perceived as providing better patient care by the most appropriate practitioner in an accessible and comfortable setting.
Ashrafi, Noushin; Kuilboer, Jean-Pierre; Joshi, Chaitanya; Ran, Iris; Pande, Priyanka
The explosive advances in information technology combined with the current climate for health care reform have intensified the need for skilled individuals who can develop, understand, and manage medical information systems in organizations. Health Informatics facilitates quality care at a reasonable cost by allowing access to the right data by…
Roy E Lee
Full Text Available Background: Last year, our pathology informatics fellowship added informatics-based interactive case studies to its existing educational platform of operational and research rotations, clinical conferences, a common core curriculum with an accompanying didactic course, and national meetings. Methods: The structure of the informatics case studies was based on the traditional business school case study format. Three different formats were used, varying in length from short, 15-minute scenarios to more formal multiple hour-long case studies. Case studies were presented over the course of three retreats (Fall 2011, Winter 2012, and Spring 2012 and involved both local and visiting faculty and fellows. Results: Both faculty and fellows found the case studies and the retreats educational, valuable, and enjoyable. From this positive feedback, we plan to incorporate the retreats in future academic years as an educational component of our fellowship program. Conclusions: Interactive case studies appear to be valuable in teaching several aspects of pathology informatics that are difficult to teach in more traditional venues (rotations and didactic class sessions. Case studies have become an important component of our fellowship′s educational platform.
Braun, Kathryn L.; Rose, Charles L.
Used medico-social analytic model to compare five long-term care programs: Skilled Nursing Facility-Intermediate Care Facility (SNF-ICF) homes, ICF homes, foster homes, day hospitals, and home care. Identified similarities and differences among programs. Preliminary findings suggest that model is useful in the evaluation and design of long-term…
Giannoni, Peggy P.; Kass, Philip H.
A retrospective cohort study was conducted to identify risk factors associated with children lost to care, and their families, compared to those not lost to care within the California Early Start Program. The cohort included data on 8987 children enrolled in the Early Start Program in 1998. This cohort consisted of 2443 children lost to care, 6363…
Cantor, Michael N
Translational informatics (TI) is extremely important for the pharmaceutical industry, especially as the bar for regulatory approval of new medications is set higher and higher. This paper will explore three specific areas in the drug development lifecycle, from tools developed by precompetitive consortia to standardized clinical data collection to the effective delivery of medications using clinical decision support, in which TI has a major role to play. Advancing TI will require investment in new tools and algorithms, as well as ensuring that translational issues are addressed early in the design process of informatics projects, and also given higher weight in funding or publication decisions. Ultimately, the source of translational tools and differences between academia and industry are secondary, as long as they move towards the shared goal of improving health.
Full Text Available The Lithuanian Informatics Olympiads (LitIO is a problem solving programming contest for students in secondary education. The work of the student to be evaluated is an algorithm designed by the student and implemented as a working program. The current evaluation process involves both automated (for correctness and performance of programs with the given input data and manual (for programming style, written motivation of an algorithm grading. However, it is based on tradition and has not been scientifically discussed and motivated. To create an improved and motivated evaluation model, we put together a questionnaire and asked a group of foreign and Lithuanian experts having experience in various informatics contests to respond. We identified two basic directions in the suggested evaluation models and made a choice based on the goals of LitIO. While designing the model in the paper, we reflected on the suggestions and opinions of the experts as much as possible, even if they were not included into the proposed model. The paper presents the final outcome of this work, the proposed evaluation model for the Lithuanian Informatics Olympiads.
Full Text Available The Computer Science, Biology, and Biomedical Informatics (CoSBBI program was initiated in 2011 to expose the critical role of informatics in biomedicine to talented high school students. By involving them in Science, Technology, Engineering, and Math (STEM training at the high school level and providing mentorship and research opportunities throughout the formative years of their education, CoSBBI creates a research infrastructure designed to develop young informaticians. Our central premise is that the trajectory necessary to be an expert in the emerging fields of biomedical informatics and pathology informatics requires accelerated learning at an early age.In our 4th year of CoSBBI as a part of the University of Pittsburgh Cancer Institute (UPCI Academy (http://www.upci.upmc.edu/summeracademy/, and our 2nd year of CoSBBI as an independent informatics-based academy, we enhanced our classroom curriculum, added hands-on computer science instruction, and expanded research projects to include clinical informatics. We also conducted a qualitative evaluation of the program to identify areas that need improvement in order to achieve our goal of creating a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics in the era of big data and personalized medicine.
Uppal, Rahul; Mandava, Gunasheil; Romagnoli, Katrina M; King, Andrew J; Draper, Amie J; Handen, Adam L; Fisher, Arielle M; Becich, Michael J; Dutta-Moscato, Joyeeta
The Computer Science, Biology, and Biomedical Informatics (CoSBBI) program was initiated in 2011 to expose the critical role of informatics in biomedicine to talented high school students. By involving them in Science, Technology, Engineering, and Math (STEM) training at the high school level and providing mentorship and research opportunities throughout the formative years of their education, CoSBBI creates a research infrastructure designed to develop young informaticians. Our central premise is that the trajectory necessary to be an expert in the emerging fields of biomedical informatics and pathology informatics requires accelerated learning at an early age.In our 4(th) year of CoSBBI as a part of the University of Pittsburgh Cancer Institute (UPCI) Academy (http://www.upci.upmc.edu/summeracademy/), and our 2nd year of CoSBBI as an independent informatics-based academy, we enhanced our classroom curriculum, added hands-on computer science instruction, and expanded research projects to include clinical informatics. We also conducted a qualitative evaluation of the program to identify areas that need improvement in order to achieve our goal of creating a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics in the era of big data and personalized medicine.
Eisenthal, Sherman; And Others
A survey of 63 general medical residents found most accepted the psychosocial role of the primary care physician, found it most appropriate in ambulatory care settings, felt ambivalent about their ability to perform it, and assigned it secondary priority in patient care. More attention by training programs to ambulatory care and psychosocial…
This paper describes research on cognitive and semantic attacks on computer systems and their users. Several countermeasures against such attacks are described, including a description of a prototype News Verifier system. It is argued that because misinformation and deception play a much more significant role in intelligence and security informatics than in other informatics disciplines such as science, medicine, and the law, a new science of intelligence and security informatics must concern itself with semantic attacks and countermeasures.
Quantum information processing and communication (QIPC) is an area of science that has two main goals: On one side, it tries to explore (still not well known) potential of quantum phenomena for (efficient and reliable) information processing and ( efficient, reliable and secure) communication. On the other side, it tries to use quantum information storing, processing and transmitting paradigms, principles, laws ,limitations, concepts, models and tools to get deeper insights into the phenomena of quantum world and to find efficient ways to describe and handle/simulate various complex physical phenomena. In order to do that QIPC has to use concepts, models, theories, methods and tools of both physics and informatics. The main role of physics at that is to discover primitive physical phenomena that can be used to design and maintain complex and reliable information storing, processing and transmitting systems. The main role of informatics is, one one side, to explore, from the information processing and communication point of view,limitations and potentials of the potential quantum information processing and communication technology, and to prepare information processing methods that could utilise potential of quantum information processing and communication technologies. On the other side, the main role of informatics is to guide and support,by theoretical tools and outcomes,physics oriented research in QIPC.
Informatization construction is an unprecedented project, so examining the implementation of its development program termly is around the comer. Besides, based on the problems found during the examinations, the program should be emended regularly to guarantee the successful implementation of the development program in the 10th Five-Year Plan of Infonnatization. The domestic research on evaluating informatization is concentrated on the estimation of social informatization. In this article, based on the analysis on the evaluating work of informatization, the midterm evaluation indices and the evaluating scheme of industrial informatization construction are discussed, and using CAAC as an exarnple,a midterm evaluation scheme of industrial informatization construction in the Five-Year Plan of Informatization is given.
The open access paradigm has become an important approach in today's information and communication society. Funders and governments in different countries stipulate open access publications of funded research results. Medical informatics as part of the science, technology and medicine disciplines benefits from many research funds, such as National Institutes of Health in the US, Wellcome Trust in UK, German Research Foundation in Germany and many more. In this study an overview of the current open access programs and conditions of major journals in the field of medical informatics is presented. It was investigated whether there are suitable options and how they are shaped. Therefore all journals in Thomson Reuters Web of Science that were listed in the subject category "Medical Informatics" in 2014 were examined. An Internet research was conducted by investigating the journals' websites. It was reviewed whether journals offer an open access option with a subsequent check of conditions as for example the type of open access, the fees and the licensing. As a result all journals in the field of medical informatics that had an impact factor in 2014 offer an open access option. A predominantly consistent pricing range was determined with an average fee of 2.248 € and a median fee of 2.207 €. The height of a journals' open access fee did not correlate with the height of its Impact Factor. Hence, medical informatics journals have recognized the trend of open access publishing, though the vast majority of them are working with the hybrid method. Hybrid open access may however lead to problems in questions of double dipping and the often stipulated gold open access.
Full Text Available The objective, necessity, means and estimated efficiency of information security cost modeling are presented. The security requirements of distributed informatics applications are determined. Aspects regarding design, development and implementation are established. Influence factors for informatics security are presented and their correlation is analyzed. The costs associated to security processes are studied. Optimal criteria for informatics security are established. The security cost of the informatics application for validating organizational identifiers is determined using theoretical assumptions made for cost models. The conclusions highlight the validity of research results and offer perspectives for future research.
U.S. Department of Health & Human Services — The Neuroimaging Informatics Tools and Resources Clearinghouse (NITRC) facilitates finding and comparing neuroimaging resources for functional and structural...
Baskaran, L N Guptha Munugoor; Greco, P J; Kaelber, D C
Medical eponyms are medical words derived from people's names. Eponyms, especially similar sounding eponyms, may be confusing to people trying to use them because the terms themselves do not contain physiologically descriptive words about the condition they refer to. Through the use of electronic health records (EHRs), embedded applied clinical informatics tools including synonyms and pick lists that include physiologically descriptive terms associated with any eponym appearing in the EHR can significantly enhance the correct use of medical eponyms. Here we describe a case example of two similar sounding medical eponyms--Wegener's disease and Wegner's disease-- which were confused in our EHR. We describe our solution to address this specific example and our suggestions and accomplishments developing more generalized approaches to dealing with medical eponyms in EHRs. Integrating brief physiologically descriptive terms with medical eponyms provides an applied clinical informatics opportunity to improve patient care.
... Care Organization Model: Request for Applications.'' FOR FURTHER INFORMATION CONTACT: Maria Alexander... http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/pioneer-aco... HUMAN SERVICES Centers for Medicare & Medicaid Services Medicare Program; Pioneer Accountable...
Song, Insu; Yellowlees, Peter; Diederich, Joachim
This book introduces approaches that have the potential to transform the daily practice of psychiatrists and psychologists. This includes the asynchronous communication between mental health care providers and clients as well as the automation of assessment and therapy. Speech and language are particularly interesting from the viewpoint of psychological assessment. For instance, depression may change the characteristics of voice in individuals and these changes can be detected by a special form of speech analysis. Computational screening methods that utilise speech and language can detect subtle changes and alert clinicians as well as individuals and caregivers. The use of online technologies in mental health, however, poses ethical problems that will occupy concerned individuals, governments and the wider public for some time. Assuming that these ethical problems can be solved, it should be possible to diagnose and treat mental health disorders online (excluding the use of medication).
Hospitals face substantial coordination challenges. To meet this hospitals more and more use standardized work processes such as care pathways. By drawing on recent coordination theory that increasingly emphasizes the role of lateral and emergent interactions alongside traditional, programmed...... mechanisms of coordination, this paper finds that standardized work processes such as care pathways should be considered as a bundle of coordination mechanisms—plans and rules, objects, routines, roles and proximity—rather than a mechanism of its own. The bundle builds the accountability, predictability...... and common understanding needed to coordinate standardized care tasks. The analysis lends theoretical insights to the traditional view that see standardized work processes as programmed processes. For health care workers who design, implement and use care pathways to solve care tasks, the analysis calls...
Andrés Felipe Ardila Rodríguez
Full Text Available The training strategies developed for the social support program bring deficits in accessibility to the chronic ill patients (EC and the CASSA-UDEC’s caretaker (CASSA-UDEC: Centre for Social Health Care at Universidad de Cundinamarca they do not have time to commute, hindering their legal relationship established by the contract. For this reason, a remote care platform (PTD was developed to support users at CASSA-UDEC improving aspects related to coverage, cost, quality, access and appropriation of information from caregivers and chronic ill patients. The design was based on gerontological constructs identifying features such as modularity, object size, usability, ergonomics, and some others, providing a friendly platform for the user with dynamic, modular and high usability content. The Platform provides a space for interaction and aid, which works as a dynamic entity in the job done by CASSA-UDEC giving support in the development of activities, expanding its coverage, access; all thanks to the benefits offered in a virtual mode.
Full Text Available The AMA Guidelines for Adolescent Preventive Services (GAPS has been the cornerstone of preventive care for teenagers since its publication in 1994. Despite this, there has been little documentation of their implementation in the family medicine literature. This article gives an overview of a family practice–based adolescent preventive health program based on GAPS recommendations, and reports on compliance, feasibility and health issues. A Community-Oriented Primary Care (COPC program targeted all adolescent patients aged 12—18 years in two Israeli family practices. 321 teenagers were invited to participate. Every 7th and 10th grader was invited for a preventive health visit with the family physician and nurse. The visits included a medical evaluation, screening and counseling regarding health issues recommended by GAPS, and counseling regarding personal health concerns. Parents were also invited to meet with the staff. 184 (57% of the adolescents invited for health visits attended. The overall visit time was 47 minutes, including 12 minutes for a questionnaire and 35 minutes with providers. Common biomedical problems included overweight, acne and dysmenorrhea. Health risk behaviors and psychosocial problems included cigarette or alcohol use, dieting, infrequent/never seat belt use, and feeling depressed. 78% wanted to discuss at least one personal health issue. 27% were invited for follow-up visits. Only 3% of the parents came for visits. A community-oriented approach facilitates bringing adolescents for preventive health visits. Many previously undetected health issues, particularly psychosocial and behavioral, are revealed during these visits. A concerns checklist aids in addressing personal health concerns.
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations...
Williams, D R; Bashshur, R L; Pool, S L; Doarn, C R; Merrell, R C; Logan, J S
This Workshop was designed to assist in the ongoing development and application of telemedicine and medical informatics to support extended space flight. Participants included specialists in telemedicine and medical/health informatics (terrestrial and space) medicine from NASA, federal agencies, academic centers, and research and development institutions located in the United States and several other countries. The participants in the working groups developed vision statements, requirements, approaches, and recommendations pertaining to developing and implementing a strategy pertaining to telemedicine and medical informatics. Although some of the conclusions and recommendations reflect ongoing work at NASA, others provided new insight and direction that may require a reprioritization of current NASA efforts in telemedicine and medical informatics. This, however, was the goal of the Workshop. NASA is seeking other perspectives and views from leading practitioners in the fields of telemedicine and medical informatics to invigorate an essential and high-priority component of the International Space Station and future extended exploration missions. Subsequent workshops will further define and refine the general findings and recommendations achieved here. NASA's ultimate aim is to build a sound telemedicine and medical informatics operational system to provide the best medical care available for astronauts going to Mars and beyond.
Williams, D. R.; Bashshur, R. L.; Pool, S. L.; Doarn, C. R.; Merrell, R. C.; Logan, J. S.
This Workshop was designed to assist in the ongoing development and application of telemedicine and medical informatics to support extended space flight. Participants included specialists in telemedicine and medical/health informatics (terrestrial and space) medicine from NASA, federal agencies, academic centers, and research and development institutions located in the United States and several other countries. The participants in the working groups developed vision statements, requirements, approaches, and recommendations pertaining to developing and implementing a strategy pertaining to telemedicine and medical informatics. Although some of the conclusions and recommendations reflect ongoing work at NASA, others provided new insight and direction that may require a reprioritization of current NASA efforts in telemedicine and medical informatics. This, however, was the goal of the Workshop. NASA is seeking other perspectives and views from leading practitioners in the fields of telemedicine and medical informatics to invigorate an essential and high-priority component of the International Space Station and future extended exploration missions. Subsequent workshops will further define and refine the general findings and recommendations achieved here. NASA's ultimate aim is to build a sound telemedicine and medical informatics operational system to provide the best medical care available for astronauts going to Mars and beyond.
Otero, Andrea Victoria; Welchering, Nils; Bermon, Anderson; Castillo, Victor; Duran, Álvaro; Castro, Javier; Muñoz, Ricardo
Abstract Background: An optimal model for telemedicine use in the international care setting has not been established. Our objective was to describe variables associated with patient outcome during the implementation of an international pediatric cardiac critical care (PCCC) telemedicine program. Materials and Methods: A retrospective review was performed of clinical records and a telemedicine database of patients admitted to the cardiac intensive care unit (CICU) at the Fundacion Cardiovascular de Colombia, Bucaramanga, Colombia, during the initial 10 months of our program, compared with patients admitted during a previous period. Information collected included demographic data, cardiac diagnosis and associated factors, Risk Adjustment for Congenital Heart Surgery (RACHS)-1 classification, and perioperative events. Primary outcome was composed of CICU and hospital mortality. Secondary outcomes were CICU and hospital length of stay (LOS). Results: Of the 553 patients who were included, teleconsultation was done for 71 (12.4%), with a total of 156 encounters, including 19 for patients on extracorporeal membrane oxygenation. Three hundred twenty-one recommendations were given, and 42 real-time interventions were documented. RACHS-1 distribution was similar between study periods (p=0.427). Teleconsulted patients were significantly younger (44 versus 24 months; p=0.03) and had higher surgical complexity than nonteleconsulted patients (p=0.01). RACHS-1 adjusted hospital survival was similar between study periods. CICU and hospital LOS intervals were significantly shorter in the telemedicine period (10 versus 17 days [p=0.02] and 22 versus 28 days [p<0.001]). In surgical cases, preoperative CICU LOS was significantly shorter (3 versus 6 days; p<0.001). Variables associated with hospital mortality were higher RACHS-1 categories, lower weight, bypass time longer than 150 min, and use of circulatory arrest, as well as the presence of sepsis or necrotizing enterocolitis
This final rule implements several provisions of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). The Affordable Care Act expands access to health insurance coverage through improvements to the Medicaid and Children's Health Insurance (CHIP) programs, the establishment of Affordable Insurance Exchanges ("Exchanges"), and the assurance of coordination between Medicaid, CHIP, and Exchanges. This final rule codifies policy and procedural changes to the Medicaid and CHIP programs related to eligibility, enrollment, renewals, public availability of program information and coordination across insurance affordability programs.
Lau, Christopher; Rogers, John M; Desai, Mina; Ross, Michael G
The obesity epidemic, including a marked increase in the prevalence of obesity among pregnant women, represents a critical public health problem in the United States and throughout the world. Over the past two decades, it has been increasingly recognized that the risk of adult health disorders, particularly metabolic syndrome, can be markedly influenced by prenatal and infant environmental exposures (ie, developmental programming). Low birth weight, together with infant catch-up growth, is associated with a significant risk of adult obesity and cardiovascular disease, as well as adverse effects on pulmonary, renal, and cerebral function. Conversely, exposure to maternal obesity or high birth weight also represents an increased risk for childhood and adult obesity. In addition, fetal exposure to select chemicals (eg, phytoestrogens) or environmental pollutants (eg, tobacco smoke) may affect the predisposition to adult disease. Animal models have confirmed human epidemiologic findings and provided insight into putative programming mechanisms, including altered organ development, cellular signaling responses, and epigenetic modifications (ie, control of gene expression without modification of DNA sequence). Prenatal care is transitioning to incorporate goals of optimizing maternal, fetal, and neonatal health to prevent or reduce adult-onset diseases. Guidelines regarding optimal pregnancy nutrition and weight gain, management of low- and high-fetal-weight pregnancies, use of maternal glucocorticoids, and newborn feeding strategies, among others, have yet to fully integrate long-term consequences on adult health.
Chung, Seon Yoon; Staggers, Nancy
Informatics competencies are a necessity for contemporary nurses. However, few researchers have investigated informatics competencies for practicing nurses. A full set of Informatics competencies, an instrument to measure these competencies, and potential influencing factors have yet to be identified for practicing nurses. The Nursing Informatics Competencies Questionnaire was designed, tested for psychometrics, and used to measure beginning and experienced levels of practice. A pilot study using 54 nurses ensured item comprehension and clarity. Internal consistency and face and content validity were established. A cross-sectional survey was then conducted on 230 nurses in Seoul, Korea, to determine construct validity, describe a complete set of informatics competencies, and explore possible influencing factors on existing informatics competencies. Principal components analysis, descriptive statistics, and multiple regression were used for data analysis. Principal components analysis gives support for the Nursing Informatics Competencies Questionnaire construct validity. Survey results indicate that involvement in a managerial position and self-directed informatics-related education may be more influential for improving informatics competencies, whereas general clinical experience and workplace settings are not. This study provides a foundation for understanding how informatics competencies might be integrated throughout nurses' work lives and how to develop appropriate strategies to support nurses in their informatics practice in clinical settings.
This final rule modernizes the Medicaid managed care regulations to reflect changes in the usage of managed care delivery systems. The final rule aligns, where feasible, many of the rules governing Medicaid managed care with those of other major sources of coverage, including coverage through Qualified Health Plans and Medicare Advantage plans; implements statutory provisions; strengthens actuarial soundness payment provisions to promote the accountability of Medicaid managed care program rates; and promotes the quality of care and strengthens efforts to reform delivery systems that serve Medicaid and CHIP beneficiaries. It also ensures appropriate beneficiary protections and enhances policies related to program integrity. This final rule also implements provisions of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) and addresses third party liability for trauma codes.
Izzo, Charles V; Smith, Elliott G; Holden, Martha J; Norton, Catherine I; Nunno, Michael A; Sellers, Deborah E
The current study examined the impact of a setting-level intervention on the prevention of aggressive or dangerous behavioral incidents involving youth living in group care environments. Eleven group care agencies implemented Children and Residential Experiences (CARE), a principle-based program that helps agencies use a set of evidence-informed principles to guide programming and enrich the relational dynamics throughout the agency. All agencies served mostly youth referred from child welfare. The 3-year implementation of CARE involved intensive agency-wide training and on-site consultation to agency leaders and managers around supporting and facilitating day-to-day application of the principles in both childcare and staff management arenas. Agencies provided data over 48 months on the monthly frequency of behavioral incidents most related to program objectives. Using multiple baseline interrupted time series analysis to assess program effects, we tested whether trends during the program implementation period declined significantly compared to the 12 months before implementation. Results showed significant program effects on incidents involving youth aggression toward adult staff, property destruction, and running away. Effects on aggression toward peers and self-harm were also found but were less consistent. Staff ratings of positive organizational social context (OSC) predicted fewer incidents, but there was no clear relationship between OSC and observed program effects. Findings support the potential efficacy of the CARE model and illustrate that intervening "upstream" at the setting level may help to prevent coercive caregiving patterns and increase opportunities for healthy social interactions.
The paper present issues regarding the audit in informatics field, the audit seen as a collaborative process and how the collaborative banking systems are audited. In this paper, the methodology and techniques for an effective audit process are described. There are highlighted some aspects regarding the assessment of collaborative systems and specific flows of informatics audit.
Full Text Available The paper present issues regarding the audit in informatics field, the audit seen as a collaborative process and how the collaborative banking systems are audited. In this paper, the methodology and techniques for an effective audit process are described. There are highlighted some aspects regarding the assessment of collaborative systems and specific flows of informatics audit.
Dalrymple, Prudence W.
The thesis of this paper is that the growth of the field of medical informatics, while seemingly a potential threat to medical librarianship, is in fact an opportunity for librarianship to both extend its reach and also to further define its unique characteristics in contrast to those of medical informatics. Furthermore, because medical…
Morris, Theodore Allan
Uses co-occurrence analysis of INSPEC classification codes and thesaurus terms assigned to medical informatics (biomedical information) journal articles and proceedings papers to reveal a more complete perspective of how information science and information technology (IS/IT) authors view medical informatics. Discusses results of cluster analysis…
Frisse, Mark E.
An analysis of the state of medical informatics, the application of computer and information technology to biomedicine, looks at trends and concerns, including integration of traditionally distinct enterprises (clinical information systems, financial information, scholarly support activities, infrastructures); informatics career choice and…
Cramm, Jane Murray; Nieboer, Anna Petra
Empirical evidence on sustainability of programs that improve the quality of care delivery over time is lacking. Therefore, this study aims to identify the predictive role of short and long term improvements in quality of chronic care delivery on program sustainability. In this longitudinal study, professionals [2010 (T0): n=218, 55% response rate; 2011 (T1): n=300, 68% response rate; 2012 (T2): n=265, 63% response rate] from 22 Dutch disease-management programs completed surveys assessing quality of care and program sustainability. Our study findings indicated that quality of chronic care delivery improved significantly in the first 2 years after implementation of the disease-management programs. At T1, overall quality, self-management support, delivery system design, and integration of chronic care components, as well as health care delivery and clinical information systems and decision support, had improved. At T2, overall quality again improved significantly, as did community linkages, delivery system design, clinical information systems, decision support and integration of chronic care components, and self-management support. Multilevel regression analysis revealed that quality of chronic care delivery at T0 (pquality changes in the first (pmanagement programs based on the chronic care model improved the quality of chronic care delivery over time and that short and long term changes in the quality of chronic care delivery predicted the sustainability of the projects.
This final rule makes regulatory changes to the Child Care and Development Fund (CCDF) based on the Child Care and Development Block Grant Act of 2014. These changes strengthen requirements to protect the health and safety of children in child care; help parents make informed consumer choices and access information to support child development; provide equal access to stable, high-quality child care for low-income children; and enhance the quality of child care and the early childhood workforce.
Joshua M. Wiener
Full Text Available Background: End-of-life care financing and delivery in the United States is fragmented and uncoordinated, with little integration of acute and long-term care services. Objective: To assess policy issues involving end-of-life care, especially involving the hospice benefit, and to analyse model programs of integrated care for people who are dying. Methods: The study conducted structured interviews with stakeholders and experts in end-of-life care and with administrators of model programs in the United States, which were nominated by the experts. Results: The two major public insurance programs—Medicare and Medicaid—finance the vast majority of end-of-life care. Both programs offer a hospice benefit, which has several shortcomings, including requiring physicians to make a prognosis of a six month life expectancy and insisting that patients give up curative treatment—two steps which are difficult for doctors and patients to make—and payment levels that may be too low. In addition, quality of care initiatives for nursing homes and hospice sometimes conflict. Four innovative health systems have overcome these barriers to provide palliative services to beneficiaries in their last year of life. Three of these health systems are managed care plans which receive capitated payments. These providers integrate health, long-term and palliative care using an interdisciplinary team approach to management of services. The fourth provider is a hospice that provides palliative services to beneficiaries of all ages, including those who have not elected hospice care. Conclusions: End-of-life care is deficient in the United States. Public payers could use their market power to improve care through a number of strategies.
Jones, Richard G; Johnson, Owen A; Batstone, Gifford
The nature of pathology services is changing under the combined pressures of increasing workloads, cost constraints and technological advancement. In the face of this, laboratory systems need to meet new demands for data exchange with clinical electronic record systems for test requesting and results reporting. As these needs develop, new challenges are emerging especially with respect to the format and content of the datasets which are being exchanged. If the potential for the inclusion of intelligent systems in both these areas is to be realised, the continued dialogue between clinicians and laboratory information specialists is of paramount importance. Requirements of information technology (IT) in pathology, now extend well beyond the provision of purely analytical data. With the aim of achieving seamless integration of laboratory data into the total clinical pathway, 'Informatics' - the art and science of turning data into useful information - is becoming increasingly important in laboratory medicine. Informatics is a powerful tool in pathology - whether in implementing processes for pathology modernisation, introducing new diagnostic modalities (e.g. proteomics, genomics), providing timely and evidence-based disease management, or enabling best use of limited and often costly resources. Providing appropriate information to empowered and interested patients - which requires critical assessment of the ever-increasing volume of information available - can also benefit greatly from appropriate use of informatics in enhancing self-management of long term conditions. The increasing demands placed on pathology information systems in the context of wider developmental change in healthcare delivery are explored in this review. General trends in medical informatics are reflected in current priorities for laboratory medicine, including the need for unified electronic records, computerised order entry, data security and recovery, and audit. We conclude that there is a
Currently,faced with the rapid development of information technology and increasing competition of the global economy,many countries have been very concerned about the issues of informatization concerning agriculture and rural areas. The level of informatization in the developed countries has been universally high,and some developing countries are also highly concerned about how to actively promote the rural market information service. With the increasing level of China’s economic development,agriculture and rural economy have placed a growing demand on informatization. From the overall perspective of agricultural and rural informatization,this paper gives a detailed analysis of current situation,goals,tasks and constraints about agricultural and rural informatization construction,and finally makes the corresponding recommendations.
Medical (health) informatics occupies the central place in all the segments of modern medicine in the past thirty years--in practical work, education and scientific research. In all that, computers have taken over the most important role and are used intensively for the development of the health information systems. Following activities develop within the area of health informatics: health-documentation, health-statistics, health-informatics and biomedical scientific and professional information. The medical informatics as the separate medical discipline very quickly gets developed, both in Bosnia and Herzegovina. In our country, the medical informatics is a separate subject for the last ten years, regarding to the Medical curriculum at the biomedical faculties in Bosnia and Herzegovina is in accordance with the project of the education related to Bologna declaration and the project EURO MEDICINA.
Quinn, Andrew M; Klepeis, Veronica E; Mandelker, Diana L; Platt, Mia Y; Rao, Luigi K F; Riedlinger, Gregory; Baron, Jason M; Brodsky, Victor; Kim, Ji Yeon; Lane, William; Lee, Roy E; Levy, Bruce P; McClintock, David S; Beckwith, Bruce A; Kuo, Frank C; Gilbertson, John R
The Partners HealthCare system's Clinical Fellowship in Pathology Informatics (Boston, MA, USA) faces ongoing challenges to the delivery of its core curriculum in the forms of: (1) New classes of fellows annually with new and varying educational needs and increasingly fractured, enterprise-wide commitments; (2) taxing electronic health record (EHR) and laboratory information system (LIS) implementations; and (3) increasing interest in the subspecialty at the academic medical centers (AMCs) in what is a large health care network. In response to these challenges, the fellowship has modified its existing didactic sessions and piloted both a network-wide pathology informatics lecture series and regular "learning laboratories". Didactic sessions, which had previously included more formal discussions of the four divisions of the core curriculum: Information fundamentals, information systems, workflow and process, and governance and management, now focus on group discussions concerning the fellows' ongoing projects, updates on the enterprise-wide EHR and LIS implementations, and directed questions about weekly readings. Lectures are given by the informatics faculty, guest informatics faculty, current and former fellows, and information systems members in the network, and are open to all professional members of the pathology departments at the AMCs. Learning laboratories consist of small-group exercises geared toward a variety of learning styles, and are driven by both the fellows and a member of the informatics faculty. The learning laboratories have created a forum for discussing real-time and real-world pathology informatics matters, and for incorporating awareness of and timely discussions about the latest pathology informatics literature. These changes have diversified the delivery of the fellowship's core curriculum, increased exposure of faculty, fellows and trainees to one another, and more equitably distributed teaching responsibilities among the entirety of the
Andrew M Quinn
Full Text Available The Partners HealthCare system′s Clinical Fellowship in Pathology Informatics (Boston, MA, USA faces ongoing challenges to the delivery of its core curriculum in the forms of: (1 New classes of fellows annually with new and varying educational needs and increasingly fractured, enterprise-wide commitments; (2 taxing electronic health record (EHR and laboratory information system (LIS implementations; and (3 increasing interest in the subspecialty at the academic medical centers (AMCs in what is a large health care network. In response to these challenges, the fellowship has modified its existing didactic sessions and piloted both a network-wide pathology informatics lecture series and regular "learning laboratories". Didactic sessions, which had previously included more formal discussions of the four divisions of the core curriculum: Information fundamentals, information systems, workflow and process, and governance and management, now focus on group discussions concerning the fellows′ ongoing projects, updates on the enterprise-wide EHR and LIS implementations, and directed questions about weekly readings. Lectures are given by the informatics faculty, guest informatics faculty, current and former fellows, and information systems members in the network, and are open to all professional members of the pathology departments at the AMCs. Learning laboratories consist of small-group exercises geared toward a variety of learning styles, and are driven by both the fellows and a member of the informatics faculty. The learning laboratories have created a forum for discussing real-time and real-world pathology informatics matters, and for incorporating awareness of and timely discussions about the latest pathology informatics literature. These changes have diversified the delivery of the fellowship′s core curriculum, increased exposure of faculty, fellows and trainees to one another, and more equitably distributed teaching responsibilities among
Han, Dong; Wang, Shuang; Jiang, Chao; Jiang, Xiaoqian; Kim, Hyeon-Eui; Sun, Jimeng; Ohno-Machado, Lucila
Biomedical Informatics is a growing interdisciplinary field in which research topics and citation trends have been evolving rapidly in recent years. To analyze these data in a fast, reproducible manner, automation of certain processes is needed. JAMIA is a "generalist" journal for biomedical informatics. Its articles reflect the wide range of topics in informatics. In this study, we retrieved Medical Subject Headings (MeSH) terms and citations of JAMIA articles published between 2009 and 2014. We use tensors (i.e., multidimensional arrays) to represent the interaction among topics, time and citations, and applied tensor decomposition to automate the analysis. The trends represented by tensors were then carefully interpreted and the results were compared with previous findings based on manual topic analysis. A list of most cited JAMIA articles, their topics, and publication trends over recent years is presented. The analyses confirmed previous studies and showed that, from 2012 to 2014, the number of articles related to MeSH terms Methods, Organization & Administration, and Algorithms increased significantly both in number of publications and citations. Citation trends varied widely by topic, with Natural Language Processing having a large number of citations in particular years, and Medical Record Systems, Computerized remaining a very popular topic in all years.
Stepped care for depression and anxiety: from primary care to specialized mental health care: a randomised controlled trial testing the effectiveness of a stepped care program among primary care patients with mood or anxiety disorders
Full Text Available Abstract Background Mood and anxiety disorders are highly prevalent and have a large impact on the lives of the affected individuals. Therefore, optimal treatment of these disorders is highly important. In this study we will examine the effectiveness of a stepped care program for primary care patients with mood and anxiety disorders. A stepped care program is characterized by different treatment steps that are arranged in order of increasing intensity. Methods This study is a randomised controlled trial with two conditions: stepped care and care as usual, whereby the latter forms the control group. The stepped care program consists of four evidence based interventions: (1 Watchful waiting, (2 Guided self-help, (3 Problem Solving Treatment and (4 Medication and/or specialized mental health care. The study population consists of primary care attendees aged 18–65 years. Screeners are sent to all patients of the participating general practitioners. Individuals with a Diagnostic and Statistical Manual of mental disorders (DSM diagnosis of major depression, dysthymia, panic disorder (with or without agoraphobia, generalized anxiety disorder, or social phobia are included as well as individuals with minor depression and anxiety disorders. Primary focus is the reduction of depressive and anxiety symptoms. Both conditions are monitored at 8, 16 and 24 weeks. Discussion This study evaluates the effectiveness of a stepped care program for patients with depressive and anxiety disorder. If effective, a stepped care program can form a worthwhile alternative for care as usual. Strengths and limitations of this study are discussed. Trial Registration Current Controlled Trails: ISRCTN17831610.
Johnston, Donna L; Halton, Jacqueline; Bassal, Mylène; Klaassen, Robert J; Mandel, Karen; Ramphal, Raveena; Simpson, Ewurabena; Peckan, Li
Providing the best care in both the inpatient and outpatient settings to pediatric oncology patients is all programs goal. Using continuous improvement methodologies, we changed from a solely team-based physician care model to a hybrid model. All patients were assigned a dedicated oncologist. There would then be 2 types of weeks of outpatient clinical service. A "Doc of the Day" week where each oncologist would have a specific day in clinic when their assigned patients would be scheduled, and then a "Doc of the Week" week where one physician would cover clinic for the week. Patient satisfaction surveys done before and 14 months after changing the model of care showed that patients were very satisfied with the care they received in both models. A questionnaire to staff 14 months after changing showed that the biggest effect was increased continuity of care, followed by more efficient clinic workflow and increased consistency of care. Staff felt it provided better planning and delivery of care. A hybrid model of care with a primary physician for each patient and assigned clinic days, alternating with weeks of single physician coverage is a feasible model of care for a medium-sized pediatric oncology program.
Ouslander, Joseph G.; Bonner, Alice; Herndon, Laurie; Shutes, Jill
INTERACT is a publicly available quality improvement program that focuses on improving the identification, evaluation, and management of acute changes in condition of nursing home residents. Effective implementation has been associated with substantial reductions in hospitalization of nursing home residents. Familiarity with and support of program implementation by medical directors and primary care clinicians in the nursing home setting are essential to effectiveness and sustainability of the program over time. In addition to helping nursing homes prevent unnecessary hospitalizations and their related complications and costs, and thereby continuing to be or becoming attractive partners for hospitals, health care systems, managed care plans, and ACOs, effective INTERACT implementation will assist nursing homes in meeting the new requirement for a robust QAPI program which is being rolled out by the federal government over the next year. PMID:24513226
Freis, Ruth; Miller, Miriam
The vendor/voucher, or purchase of service, system for child care delivery is discussed as a logical model for communities which are looking for a method of developing a new system or have outgrown their current program. Discussion initially focuses on the increasing need for child care, cost/benefit aspects of child care, the regulation of child…
... 42 Public Health 5 2010-10-01 2010-10-01 false Conviction relating to program or health care fraud... Permissive Exclusions § 1001.201 Conviction relating to program or health care fraud. (a) Circumstance for... misdemeanor relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other...
J.M. Cramm (Jane); A.P. Nieboer (Anna)
markdownabstractEmpirical evidence on sustainability of programs that improve the quality of care delivery over time is lacking. Therefore, this study aims to identify the predictive role of short and long term improvements in quality of chronic care delivery on program sustainability. In this lon
... AFFAIRS Pilot Program of Enhanced Contract Care Authority for Veterans in Highly Rural Areas AGENCY... implementing Sec. 403 of Public Law (Pub. L.) 110-387, ``Veterans' Mental Health and Other Care Improvements Act of 2008,'' which requires VA to establish a pilot program to contract with non-VA health...
Lee, Linda; Weston, W. Wayne; Hillier, Loretta M.
Introduction: Primary care is challenged to meet the needs of patients with dementia. A training program was developed to increase capacity for dementia care through the development of Family Health Team (FHT)-based interprofessional memory clinics. The interprofessional training program consisted of a 2-day workshop, 1-day observership, and 2-day…
Briley, Margaret E.; Grey, Cynthia R.
Presents information on standards for American child care and early education programs participating in the Child and Adult Care Food Program. Topics discussed include meal plans, nutritional requirements, food preparation and food service, cultural diversity, food safety and sanitation, nutrition education, and emotional climate at mealtimes. (KB)
Schubart, Jane R; Levi, Benjamin H; Camacho, Fabian; Whitehead, Megan; Farace, Elana; Green, Michael J
Despite widespread efforts to promote advance directives (ADs), completion rates remain low. Making Your Wishes Known: Planning Your Medical Future (MYWK) is an interactive computer program that guides individuals through the process of advance care planning, explaining health conditions and interventions that commonly involve life or death decisions, helps them articulate their values/goals, and translates users' preferences into a detailed AD document. The purpose of this study was to demonstrate that (in the absence of major life changes) the AD generated by MYWK reliably reflects an individual's values/preferences. English speakers ≥30 years old completed MYWK twice, 4 to 6 weeks apart. Reliability indices were assessed for three AD components: General Wishes; Specific Wishes for treatment; and Quality-of-Life values (QoL). Twenty-four participants completed the study. Both the Specific Wishes and QoL scales had high internal consistency in both time periods (Knuder Richardson formula 20 [KR-20]=0.83-0.95, and 0.86-0.89). Test-retest reliability was perfect for General Wishes (κ=1), high for QoL (Pearson's correlation coefficient=0.83), but lower for Specific Wishes (Pearson's correlation coefficient=0.57). MYWK generates an AD where General Wishes and QoL (but not Specific Wishes) statements remain consistent over time.
Hincapie, Ana L; Cutler, Timothy W; Fingado, Amanda R
Objective. To incorporate a pharmacy informatics program in the didactic curriculum of a team-based learning institution and to assess students' knowledge of and confidence with health informatics during the course. Design. A previously developed online pharmacy informatics course was adapted and implemented into a team-based learning (TBL) 3-credit-hour drug information course for doctor of pharmacy (PharmD) students in their second didactic year. During a period of five weeks (15 contact hours), students used the online pharmacy informatics modules as part of their readiness assurance process. Additional material was developed to comply with the TBL principles. Online pre/postsurveys were administered to evaluate knowledge gained and students' perceptions of the informatics program. Assessment. Eighty-three second-year students (84% response rate) completed the surveys. Participants' knowledge of electronic health records, computerized physician order entry, pharmacy information systems, and clinical decision support was significantly improved. Additionally, their confidence significantly improved in terms of describing health informatics terminology, describing the benefits and barriers of using health information technology, and understanding reasons for systematically processing health information. Conclusion. Students responded favorably to the incorporation of pharmacy informatics content into a drug information course using a TBL approach. Students met the learning objectives of seven thematic areas and had positive attitudes toward the course after its completion.
Dill, Janette S; Chuang, Emmeline; Morgan, Jennifer C
Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization.
Petersen, Cheryl L; Callahan, Margaret Faut; McCarthy, Donna O; Hughes, Ronda G; White-Traut, Rosemary; Bansal, Naveen K
This study evaluated the potential impact of an online spiritual care educational program on pediatric nurses' attitudes toward and knowledge of spiritual care and their competence to provide spiritual care to children with cancer at the end of life. It was hypothesized that the intervention would increase nurses' positive attitudes toward and knowledge of spiritual care and increase nurses' level of perceived spiritual care competence. A positive correlation was expected between change in nurses' perceived attitudes toward and knowledge of spiritual care and change in nurses' perceived spiritual care competence. A prospective, longitudinal design was employed, and analyses included one-way repeated-measures analysis of variance, linear regression, and partial correlation. Statistically significant differences were found in nurses' attitudes toward and knowledge of spiritual care and nurses' perceived spiritual care competence. There was a positive relationship between change scores in nurses' attitudes toward and knowledge of spiritual care and nurses' spiritual care competence. Online spiritual care educational programs may exert a lasting impact on nurses' attitudes toward and knowledge of spiritual care and their competence to provide spiritual care to children with cancer at the end of life. Additional studies are required to evaluate the direct effects of educational interventions patient outcomes.
Materials informatics is a cross discipline combining materials science and information science. The concept of materials informatics was introduced and expounded. The current status of research and application of materials informatics was analyzed. And the main tasks and research areas of materials informatics were summarized. Then the foundation and significance of its development in China was discussed. Lastly the development vision of materials informatics was proposed.
Shi Chunsheng(石春生); Han Xinjuan; Yang Cuilan; Zhao Dongbai
The basic conditions of the enterprise informatization in Heilongjiang province are analyzed and 4 models are designed to drive the industrial and commercial information enterprise. The 4 models are the Resource Integration Informatization Model, the Flow Management Informatization Model, the Intranet E-commerce Informatization Model and the Network Enterprise Informatization Model. The conditions for using and problems needing attentions of these 4 models are also analyzed.
Gray Leonard C
Full Text Available Abstract Background An increasing demand for acute care services due in part to rising proportions of older people and increasing rates of chronic diseases has led to new models of post-acute care for older people that offer coordinated discharge, ongoing support and often a focus on functional restoration. Overall, review of the literature suggests there is considerable uncertainty around the effectiveness and resource implications of the various model configurations and delivery approaches. In this paper, we review the current evidence on the efficacy of such programs, using the Australian Transition Care Program as a case study. Discussion The Australian Transition Care Program was established at the interface of the acute and aged care sectors with particular emphasis on transitions between acute and community care. The program is intended to enable a significant proportion of care recipients to return home, rather than prematurely enter residential aged care, optimize their functional capacity, and reduce inappropriate extended lengths of hospital stay for older people. Broadly, the model is configured and targeted in accordance with programs reported in the international literature to be effective. Early evaluations suggest good acceptance of the program by hospitals, patients and staff. Ultimately, however, the program's place in the array of post-acute services should be determined by its demonstrated efficacy relative to other services which cater for similar patient groups. Summary Currently there is a lack of robust evaluation to provide convincing evidence of efficacy, either from a patient outcome or cost reduction perspective. As the program expands and matures, there will be opportunity to scrutinise the systematic effects, with lessons for both Australian and international policy makers and clinical leaders.
Arocha José F
Full Text Available Abstract Background The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional differentiation between implicit and explicit knowledge we outline the concepts of general and individual knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based reasoning, a method of individual knowledge processing that aims at solving new problems based on the solutions to similar past problems. We outline the fundamental differences between Medical Informatics and theoretical sciences and propose that Medical Informatics research should advance individual knowledge processing (case-based reasoning and that natural language processing research is an important step towards this goal that may have ethical implications for patient-centered health medicine. Discussion We focus on fundamental aspects of decision-making, which connect human expertise with individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized healthcare and that can enable the education of patients and providers. We center the discussion on formal methods of knowledge representation around the frame problem. We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based reasoning research and natural language processing. In the context of memory based knowledge processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to naturally support the case-based reasoning paradigm (memory of past experiences
Jadad Alejandro R
Full Text Available Abstract Background Chronic diseases affect millions of children worldwide leading to substantial disease burden to the children and their families as well as escalating health care costs. The increasing trend in the prevalence of complex pediatric chronic diseases requires innovative and optimal delivery of care. Biomedical informatics applications play an important role in improving health outcomes while being cost-effective. However, their utility in pediatric chronic diseases has not been studied in a comprehensive and systematic way. The objective of this study was to conduct a systematic review of the effects of biomedical informatics applications in pediatric chronic diseases. Methods A comprehensive literature search was conducted using MEDLINE, the Cochrane Library and EMBASE databases from inception of each database to September 2008. We included studies of any methodological type and any language that applied biomedical informatics to chronic conditions in children and adolescents 18 years of age or younger. Two independent reviewers carried out study selection and data extraction. Quality assessment was performed using a study design evaluation instrument to appraise the strength of the studies and their methodological adequacy. Because of heterogeneity in the conditions and outcomes we studied, a formal meta-analysis was not performed. Results Based on our search strategy, 655 titles and abstracts were reviewed. From this set we identified 27 relevant articles that met our inclusion criteria. The results from these studies indicated that biomedical informatics applications have favourable clinical and patient outcomes including, but not limited to, reduced number of emergency room visits, improved knowledge on disease management, and enhanced satisfaction. Seventy percent of reviewed papers were published after year 2000, 89% of users were patients and 11% were either providers or caregivers. The majority (96% of the selected
Gang Wang; Zhi-Wei Jiang; Jing Xu; Jian-Feng Gong; Yang Bao; Li-Fei Xie; Jie-Shou Li
AIM: To compare the fast-track rehabilitation program and conventional care for patients after resection of colorectal cancer.METHODS: One hundred and six consecutive patients who underwent fast-track rehabilitation program were encouraged to have early oral feeding and movement for early discharge, while 104 consecutive patients underwent conventional care after resection of colorectal cancer. Their gastrointestinal functions, postoperative complications and hospital stay time were recorded.RESULTS: The restoration time of gastrointestinal functions in the patients was significantly faster after fasttrack rehabilitation program than after conventional care (2.1 d vs 3.2 d, P < 0.01). The percentage of patients who developed complications was significantly lower 30 d after fast-track rehabilitation program than after conventional care (13.2% vs 26.9%, P < 0.05). Also,the percentage of patients who had general complications was significantly lower 30 d after fast-track rehabilitation program than after conventional care (6.6% vs 15.4%, P < 0.05). The postoperative hospital stay time of the patients was shorter after fast-track rehabilitation program than after conventional care (5 d vs 7 d, P <0.01). No significant difference was observed in the readmission rate 30 d after fast-track rehabilitation program and conventional care (3.8% vs 8.7%).CONCLUSION: The fast-track rehabilitation program can significantly decrease the complications and shorten the time of postoperative hospital stay of patients after resection colorectal cancer.
Khonsari, L S; Fabri, P J
The advent of healthcare reform and the rapid application of new technologies have resulted in a paradigm shift in medical practice. Integrating medical Informatics into the full spectrum of medical education is a viral step toward implementing this new instructional model, a step required for the understanding and practice of modern medicine. We have developed an informatics curriculum, a new educational paradigm, and an intranet-based teaching module which are designed to enhance adult-learning principles, life-long self education, and evidence-based critical thinking. Thirty two, fourth year medical students have participated in a one month, full time, independent study focused on but not limited to four topics: mastering the windows-based environment, understanding hospital based information management systems, developing competence in using the internet/intranet and world wide web/HTML, and experiencing distance communication and TeleVideo networks. Each student has completed a clinically relevant independent study project utilizing technology mastered during the course. This initial curriculum offering was developed in conjunction with faculty from the College of Medicine, College of Engineering, College of Education, College of Business, College of Public Health. Florida Center of Instructional Technology, James A. Haley Veterans Hospital, Moffitt Cancer Center, Tampa General Hospital, GTE, Westshore Walk-in Clinic (paperless office), and the Florida Engineering Education Delivery System. Our second step toward the distributive integration process was the introduction of Medical Informatics to first, second and third year medical students. To date, these efforts have focused on undergraduate medical education. Our next step is to offer workshops in Informatics to college of medicine faculty, to residents in post graduate training programs (GME), and ultimately as a method of distance learning in continuing medical education (CME).
Blum, Cynthia A
Self-care is imperative to personal health, sustenance to continue to care for others, and professional growth. This article briefly reviews stressors common to students and nurses and the importance of practicing self-care to combat stress and promote health in practice. Florida Atlantic University offers a course for all levels of undergraduate nursing students called Caring for Self. The course, supported by principles of Adult Learning Theory, focuses on guiding the nurse to practice and model self-care. The author describes the evolution of this self-care initiative by discussing the needs assessment, course description and strategies, examples of course activities, and an exemplar of student impact. The conclusion offers discussion of challenges and lessons noted by faculty and students.
Full Text Available Paul Y Takahashi,1 Anupam Chandra,1 Frederick North,1 Jennifer L Pecina,2 Benjavan Upatising,3 Gregory J Hanson11Mayo Clinic Division of Primary Care Internal Medicine, 2Mayo Clinic Department of Family Medicine, Rochester, MN, USA; 3Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, IN, USAAbstract: Recent changes and consolidations in health care systems have resulted in an increase in new health care delivery models. Telemedicine holds great promise as one of these models. There is a great potential for new patient evaluation and treatment models in emergency care (EC, especially when patients are miles away from a medical team. Evaluations can be performed in a patient's home, a nursing care facility, and in hospitals that focus on advanced subspecialty care. Due to rapid developments in this area, current care models are constantly being evaluated and modified. This review article outlines current telemedicine models for EC and summarizes their potential benefits to patients and the health care system. The review examines the role that the telephone, a fundamental tool of telemedicine, plays in these new models. The review also examines evidence of improved health care outcomes by highlighting the role of telemedicine in reducing hospitalizations. The patient is the primary focus; as a result, this review also examined patient experiences and satisfaction levels regarding telemedicine health care teams. The authors support these technological advances and their potential for information transfer. Health care providers need to continue developing these models by making use of increasing amounts of information. One of the main implementation barriers of these new models in the US and other countries is the issue of payment and reimbursement. Despite this, advancements in EC telemedicine continue.Keywords: telemedicine, emergency care, geriatric, patient evaluation models
This volume presents the proceedings of the International Conference on Health Informatics (ICHI). The conference was a new special topic conference initiative by the International Federation of Medical and Biological Engineering (IFMBE), held in Vilamoura, Portugal on 7-9 November, 2013. The main theme of the ICHI2013 was “Integrating Information and Communication Technologies with Biomedicine for Global Health”. The proceedings offer a unique forum to examine enabling technologies of sensors, devices and systems that optimize the acquisition, transmission, processing, storage, retrieval of biomedical and health information as well as to report novel clinical applications of health information systems and the deployment of m-Health, e-Health, u-Health, p-Health and Telemedicine.
Shirai, Hiroki; Prades, Catherine; Vita, Randi;
to the antibody science in every project in antibody drug discovery. Recent experimental technologies allow for the rapid generation of large-scale data on antibody sequences, affinity, potency, structures, and biological functions; this should accelerate drug discovery research. Therefore, a robust bioinformatic...... infrastructure for these large data sets has become necessary. In this article, we first identify and discuss the typical obstacles faced during the antibody drug discovery process. We then summarize the current status of three sub-fields of antibody informatics as follows: (i) recent progress in technologies...... for antibody rational design using computational approaches to affinity and stability improvement, as well as ab-initio and homology-based antibody modeling; (ii) resources for antibody sequences, structures, and immune epitopes and open drug discovery resources for development of antibody drugs; and (iii...
Full Text Available Background. Persons living with dementia in the long-term care home (LTCH setting have a number of unique needs, including those related to planning for their futures. It is therefore important to understand the advance care planning (ACP programs that have been developed and their impact in order for LTCH settings to select a program that best suits residents’ needs. Methods. Four electronic databases were searched from 1990 to 2013, for studies that evaluated the impact of advance care planning programs implemented in the LTCH setting. Studies were critically reviewed according to rigour, impact, and the consideration of the values of residents with dementia and their family members according to the Dementia Policy Lens Toolkit. Results and Conclusion. Six ACP programs were included in the review, five of which could be considered more “dementia friendly.” The programs indicated a variety of positive impacts in the planning and provision of end-of-life care for residents and their family members, most notably, increased ACP discussion and documentation. In moving forward, it will be important to evaluate the incorporation of residents with dementia’s values when designing or implementing ACP interventions in the LTCH settings.
Taylor, April; Lizzi, Michele; Marx, Alison; Chilkatowsky, Maryann; Trachtenberg, Symme W; Ogle, Sue
Care coordination has been a key theme in national forums on healthcare quality, design, and improvement. This article describes the characteristics of a care coordination program aimed at supporting families in building care coordination competencies and providers in the coordination of care across multiple specialties. The program included implementation of a Care Coordination Counselor (CC Counselor) and several supporting tools-Care Binders, Complex Scheduling, Community Resources for Families Database, and a Care Coordination Network. Patients were referred by a healthcare provider to receive services from the CC Counselor or to receive a Care Binder organizational tool. To assess the impact of the counselor role, we compared patient experience survey results from patients receiving CC Counselor services to those receiving only the Care Binder. Our analysis found that patients supported by the CC Counselor reported greater agreement with accessing care coordination resources and identifying a key point person for coordination. Seventy-five percent of CC Counselor patients have graduated from the program. Our findings suggest that implementation of a CC Counselor role and supporting tools offers an integrative way to connect patients, families, and providers with services and resources to support coordinated, continuous care.
Gennady N. Zverev
Full Text Available This paper defines the goals and problems of fundamental informatics, formulates principal laws of information universe and constructive bases of information objects and processes. The classification of semantics types of knowledge and skills is presented.
... improvement, and meaningful use of health information technology can achieve the three-part aim of better care... Center's approach to supporting comprehensive primary care. Learning systems will support participating... savings will not be a part of the payment methodology for Medicaid fee-for-service. III. Collection...
The Intelligent Systems Series comprises titles that present state of the art knowledge and the latest advances in intelligent systems. Its scope includes theoretical studies, design methods, and real-world implementations and applications. Traditionally, Intelligence and Security Informatics (ISI) research and applications have focused on information sharing and data mining, social network analysis, infrastructure protection and emergency responses for security informatics. With the continuous advance of IT technologies and the increasing sophistication of national and international securi
L M G Steuten
Full Text Available L M G Steuten1, K M M Lemmens2, A P Nieboer2, H JM Vrijhoef31Maastricht University Medical Centre, School for Care and Public Health Research, Department of Health, Organisation, Policy and Economics, Maastricht, The Netherlands; 2Erasmus University Medical Centre, Institute of Health Policy and Management, Rotterdam, The Netherlands; 3Maastricht University Medical Centre, School for Care and Public Health Research, Department of Integrated Care, Maastricht, The NetherlandsObjective: To review published evidence regarding the cost effectiveness of multi-component COPD programs and to illustrate how potentially cost effective programs can be identified.Methods: Systematic search of Medline and Cochrane databases for evaluations of multi-component disease management or chronic care programs for adults with COPD, describing process, intermediate, and end results of care. Data were independently extracted by two reviewers and descriptively summarized.Results: Twenty articles describing 17 unique COPD programs were included. There is little evidence for significant improvements in process and intermediate outcomes, except for increased provision of patient self-management education and improved disease-specific knowledge. Overall, the COPD programs generate end results equivalent to usual care, but programs containing ≥3 components show lower relative risks for hospitalization. There is limited scope for programs to break-even or save money.Conclusion: Identifying cost effective multi-component COPD programs remains a challenge due to scarce methodologically sound studies that demonstrate significant improvements on process, intermediate and end results of care. Estimations of potential cost effectiveness of specific programs illustrated in this paper can, in the absence of ‘perfect data’, support timely decision-making regarding these programs. Nevertheless, well-designed health economic studies are needed to decrease the current decision
Griffin, Brenda; Bushby, Philip A; McCobb, Emily; White, Sara C; Rigdon-Brestle, Y Karla; Appel, Leslie D; Makolinski, Kathleen V; Wilford, Christine L; Bohling, Mark W; Eddlestone, Susan M; Farrell, Kelly A; Ferguson, Nancy; Harrison, Kelly; Howe, Lisa M; Isaza, Natalie M; Levy, Julie K; Looney, Andrea; Moyer, Michael R; Robertson, Sheilah Ann; Tyson, Kathy
As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners. In an effort to promote consistent, high-quality care across the broad range of these programs, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. These guidelines consist of recommendations for general patient care and clinical procedures, preoperative care, anesthetic management, surgical procedures, postoperative care, and operations management. They were based on current principles of anesthesiology, critical care medicine, infection control, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs regardless of location, facility, or type of program. The Association of Shelter Veterinarians envisions that these guidelines will be used by the profession to maintain consistent veterinary medical care in all settings where spay-neuter services are provided and to promote these services as a means of reducing sheltering and euthanasia of cats and dogs.
Sendi, Pedram; Al, Maiwenn J; Zimmermann, Heinz
The league table approach to rank ordering health care programs according to the incremental cost-effectiveness ratio is a common method to guide policy makers in setting priorities for resource allocation. In the presence of uncertainty, however, ranking programs is complicated by the degree of variability associated with each program. Confidence intervals for cost-effectiveness ratios may be overlapping. Moreover, confidence intervals may include negative ratios and the interpretation of negative cost-effectiveness ratios is ambiguous. We suggest to rank mutually exclusive health care programs according to their rate of return which is defined as the net monetary benefit over the costs of the program. However, how does a program with a higher expected return but higher uncertainty compare to a program with a lower expected return but lower risk? In the present paper we propose a risk-adjusted measure to compare the return on investment in health care programs. Financing a health care program is treated as an investment in a risky asset. The risky asset is combined with a risk-free asset in order to construct a combined portfolio. The weights attributed to the risk-free and risky assets are chosen in such a manner that all programs under consideration exhibit the same degree of uncertainty. We can then compare the performance of the individual programs by constructing a risk-adjusted league table of expected returns.
In January 1993 the Joint European Project "Education in the methodology field of health care", EuroMISE (European Education in Medical Informatics, Statistics and Epidemiology) started under the European TEMPUS program. Training and education in EuroMISE consist of three overlapping methodology branches: medical informatics, medical statistics, and epidemiology. A teaching scheme has been developed in cooperation between Charles University, Prague, and EC universities and organizations involved in the EuroMISE project. One of the main tasks of the project is to design a modularly structured EuroMISE course set, to develop teaching materials and tools in the English language, and to link the EuroMISE project with other programs and projects in this field. Running EuroMISE courses, firstly for university teachers, will have a major impact in disseminating the acquired knowledge and skills.
Michael J. Stewart
Full Text Available Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice. The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt. Methods: Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis. Results: 45 journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional
Michael J. Stewart
Full Text Available Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice. The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt.Methods: Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis.Results: 45 journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional
... June 30, 2013, on July 24, 2012, in the Federal Register at 77 FR 43229. Adjusted Payments The... related notice published at 48 FR 29114, June 24, 1983.) This notice has been determined to be not... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day...
Rabello, Cláudia Azevedo Ferreira Guimarães; Rodrigues, Paulo Henrique de Almeida
This study discusses the creation of a new children palliative care program based on the Family Health Program, considering the level of care at home and yielding to family requests. The study focused on eighteen members of nine families of technology dependent children (TDC) who were hospital patients at Instituto Fernandes Figueira (IFF): four who are being assisted by its palliative care program Programa de Assistência Domiciliar Interdisciplinar (PADI); three who were inpatients waiting for inclusion in the Program, and finally two inpatients already included in PADI. PADI was chosen because it is the only child palliative care program in Brazil. The results are positive in regards to the connection established between the families and the health care team, the reception of the children, the explanation to the family concerning the disease, and the functional dynamics between the PADI and IFF. As negative points, difficulties arose as a result of the implementation of the program, from its continuity to the worsening or illness of the entire family. In conclusion, although the PADI is the IFF's way of discharging patients, the domiciliary cares taken by the Family Health Program, well articulated with the healthcare system, would be ideal for being the adequate assistance for such.
Wiley, Laura K; Tarczy-Hornoch, Peter; Denny, Joshua C; Freimuth, Robert R; Overby, Casey L; Shah, Nigam; Martin, Ross D; Sarkar, Indra Neil
The American Medical Informatics Association convened the 2014 Health Policy Invitational Meeting to develop recommendations for updates to current policies and to establish an informatics research agenda for personalizing medicine. In particular, the meeting focused on discussing informatics challenges related to personalizing care through the integration of genomic or other high-volume biomolecular data with data from clinical systems to make health care more efficient and effective. This report summarizes the findings (n = 6) and recommendations (n = 15) from the policy meeting, which were clustered into 3 broad areas: (1) policies governing data access for research and personalization of care; (2) policy and research needs for evolving data interpretation and knowledge representation; and (3) policy and research needs to ensure data integrity and preservation. The meeting outcome underscored the need to address a number of important policy and technical considerations in order to realize the potential of personalized or precision medicine in actual clinical contexts.
Brandt, Karsten; Löbe, Matthias; Schaaf, Michael; Jahn, Franziska; Winter, Alfred; Stäubert, Sebastian
Medical research and health care highly depend on the use of information technology. There is a wide range of application systems (patient administration system, laboratory information system, communication server etc.) and heterogeneous data types (administrative data, clinical data, laboratory data, image data, genomic data etc.). Students and researchers do not often have the possibility to use productive application systems of e.g. hospitals or medical practices to gain practical experiences or examine new components and technologies. Therefore, the aim of this project is to develop a dedicated laboratory environment for patient health care and clinical research. Essential application systems were identified and a suitable architecture was designed for this purpose. It is accompanied by a teaching plan that considers learning modules for bachelor and master degrees in medical informatics. We implemented the laboratory environment called MI-Lab with multiple free and open source software components. All components are installed on virtual machines and/or Docker containers. This modular architecture creates a flexible system which can be deployed in various scenarios. The preliminary evaluation results suggests that laboratory environments like MI-Lab work well in teaching practical aspects of medical informatics and are widely accepted by students.
Carrico, Ruth M; Sorrells, Nikka; Westhusing, Kelly; Wiemken, Timothy
Recent studies have identified concerns with various elements of health care personnel immunization programs, including the handling and management of the vaccine. The purpose of this study was to assess monitoring processes that support evaluation of the care of vaccines in health care settings. An 11-question survey instrument was developed for use in scripted telephone surveys. State health departments in all 50 states in the United States and the District of Columbia were the target audience for the surveys. Data from a total of 47 states were obtained and analyzed. No states reported an existing monitoring process for evaluation of health care personnel immunization programs in their states. Our assessment indicates that vaccine evaluation processes for health care facilities are rare to nonexistent in the United States. Identifying existing practice gaps and resultant opportunities for improvements may be an important safety initiative that protects patients and health care personnel.
Marceglia, Sara; Bonacina, Stefano; Mazzola, Luca; Pinciroli, Francesco
For a common user, bioimages seem to be very easy to treat, to read, to understand and, therefore, to archive. Conversely, bioimage archiving require a very complex design and implementation process that needs skilled and trained technicians. We proposed to a class of bioengineering students at the Politecnico University of Milan the implementation of a hand image repository specifically designed for highlighting the main features that should be taken into account when treating bioimage archives. Students were required to build the archive with software tools they had previously learned in other programming language courses and available at the university informatics class-rooms.
Leeman, Jennifer; Mark, Barbara
The present article applies transaction cost analysis as a framework for better understanding health plans' decisions to improve chronic illness management by using disease management programs versus redesigning care within physician practices.
Vonhermann, Pieter; Pintz, Adam
This manual describes the use of the ANSCARES program to prepare a neutral file of FEM stress results taken from ANSYS Release 5.0, in the format needed by CARES/LIFE ceramics reliability program. It is intended for use by experienced users of ANSYS and CARES. Knowledge of compiling and linking FORTRAN programs is also required. Maximum use is made of existing routines (from other CARES interface programs and ANSYS routines) to extract the finite element results and prepare the neutral file for input to the reliability analysis. FORTRAN and machine language routines as described are used to read the ANSYS results file. Sub-element stresses are computed and written to a neutral file using FORTRAN subroutines which are nearly identical to those used in the NASCARES (MSC/NASTRAN to CARES) interface.
Ammenwerth, E; Knaup, P; Maier, C; Mludek, V; Singer, R; Skonetzki, S; Wolff, A C; Haux, R; Kulikowski, C
The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of recent excellent papers on medical informatics research (http://www.med.uni-heidelberg.de/mi/yearbook/index.htm). The special topic of the just published Yearbook 2001 is "Digital Libraries and Medicine". Digital libraries have changed dramatically and will continue to change the way we work with medical knowledge. The selected papers present recent research and new results on digital libraries. As usual, the Yearbook 2001 also contains a variety of papers on other subjects relevant to medical informatics, such as Electronic Patient Records, Health Information Systems, Health and Clinical Management, Decision Support Systems, Education, as well as Image and Signal Processing. This paper will briefly introduce the contributions covering digital libraries and will show how medical informatics research contributes to this important topic.
Meret-Hanke, Louise A.
Purpose of the Study: This study evaluates the effects of the Program of All-Inclusive Care for the Elderly (PACE) on hospital use. PACE's capitated financing creates incentives to reduce the use of costly services. Furthermore, its emphasis on preventative care and regular monitoring by provides a mechanism for reducing unnecessary hospital use…
Brown, Corinne; Bornstein, Elizabeth; Wilcox, Catina
The Partnership and Empowerment Program model offers a comprehensive, patient-centered, and cost-effective template for coordinating care for underinsured and uninsured patients with cancer. Attention to effective coordination, including use of internal and external resources, may result in decreased costs of care and improved patient compliance and health outcomes.
This study identified behavioral and organizational barriers and facilitators related to the implementation of a clinic-based pediatric injury prevention program. Safe N′ Sound (SNS), an evidence-based tailored injury prevention program designed for pediatric primary care, was implemented in five pediatric clinics in North Carolina. Office managers participated in structured interviews; health care providers participated in focus groups. Waiting room observations were conducted in participati...
Cantón Sonia; Acosta Benjamín; Reyes Hortensia; Levy Santiago; Pérez-Cuevas Ricardo; Gutiérrez Gonzalo; Muñoz Onofre
Abstract Background In 2001, the Instituto Mexicano del Seguro Social (IMSS) carried out a major reorganization to provide comprehensive preventive care to reinforce primary care services through the PREVENIMSS program. This program divides the population into programmatic age groups that receive specific preventive services: children (0-9 years), adolescents (10-19 years), men (20-59 years), women (20-59 years) and older adults (> = 60 years). The objective of this paper is to describe the i...
Full Text Available OBJECTIVE: Older adults are at risk of rehospitalization if their care transitions from hospital-to-home are not properly managed. The objective of this review was to determine if older patient populations recruited for randomized controlled trials of transitional care interventions represented those at greatest risk of rehospitalization following discharge. Relevant risk factors examined were cognitive impairment, depression, polypharmacy, comorbidity, length of stay, advanced non-malignant diseases, and available social support.DESIGN: Systematic Review.SETTING: Hospital to home.PARTICIPANTS: Older hospitalized adults.MEASUREMENTS: For inclusion, articles were required to focus on hospital-to-home transitions with a self-care component, have components occurring both before and after discharge, and a randomized controlled trial design. Articles were excluded if participants had a mean age under 55 years, or if interventions focused on developmental disabilities, youth, addictions, or case management, or were solely primary-care based.RESULTS: Following title, abstract, and full review by two authors, 17 articles met inclusion criteria. Risk factors for rehospitalization were often listed either as exclusion criteria or were not reported at baseline by the studies. One study included patients with all identified risk factors for rehospitalization.CONCLUSIONS: These data suggest that published studies of transitional care interventions do not often include older adults at highest risk of rehospitalization, raising concerns about the generalizability of their results. Studies are needed that evaluate interventions that explicitly address the needs and characteristics of these patients.
Full Text Available OBJECTIVE: Older adults are at risk of rehospitalization if their care transitions from hospital-to-home are not properly managed. The objective of this review was to determine if older patient populations recruited for randomized controlled trials of transitional care interventions represented those at greatest risk of rehospitalization following discharge. Relevant risk factors examined were cognitive impairment, depression, polypharmacy, comorbidity, length of stay, advanced non-malignant diseases, and available social support. DESIGN: Systematic Review. SETTING: Hospital to home. PARTICIPANTS: Older hospitalized adults. MEASUREMENTS: For inclusion, articles were required to focus on hospital-to-home transitions with a self-care component, have components occurring both before and after discharge, and a randomized controlled trial design. Articles were excluded if participants had a mean age under 55 years, or if interventions focused on developmental disabilities, youth, addictions, or case management, or were solely primary-care based. RESULTS: Following title, abstract, and full review by two authors, 17 articles met inclusion criteria. Risk factors for rehospitalization were often listed either as exclusion criteria or were not reported at baseline by the studies. One study included patients with all identified risk factors for rehospitalization. CONCLUSIONS: These data suggest that published studies of transitional care interventions do not often include older adults at highest risk of rehospitalization, raising concerns about the generalizability of their results. Studies are needed that evaluate interventions that explicitly address the needs and characteristics of these patients.
Borne, K. D.
The discipline of data science is merging with multiple science disciplines to form new X-informatics research disciplines. They are almost too numerous to name, but they include geoinformatics, bioinformatics, cheminformatics, biodiversity informatics, ecoinformatics, materials informatics, and the emerging discipline of astroinformatics. Within any X-informatics discipline, the information granules are unique to that discipline -- e.g., gene sequences in bio, the sky object in astro, and the spatial object in geo (such as points, lines, and polygons in the vector model, and pixels in the raster model). Nevertheless the goals are similar: transparent data re-use across subdisciplines and within education settings, information and data integration and fusion, personalization of user interactions with the data collection, semantic search and retrieval, and knowledge discovery. The implementation of an X-informatics framework enables these semantic e-science research goals. We describe the concepts, challenges, and new developments associated with the new discipline of astroinformatics, and how geoinformatics provides valuable lessons learned and a model for practical semantic science within a traditional science discipline through the accretion of data science methodologies (such as formal metadata creation, data models, data mining, information retrieval, knowledge engineering, provenance, taxonomies, and ontologies). The emerging concept of data-as-a-service (DaaS) builds upon the concept of smart data (or data DNA) for intelligent data management, automated workflows, and intelligent processing. Smart data, defined through X-informatics, enables several practical semantic science use cases, including self-discovery, data intelligence, automatic recommendations, relevance analysis, dimension reduction, feature selection, constraint-based mining, interdisciplinary data re-use, knowledge-sharing, data use in education, and more. We describe these concepts within the
Nemeth, Noel N.; Powers, Lynn M.; Janosik, Lesley A.; Gyekenyesi, John P.
This manual describes the Ceramics Analysis and Reliability Evaluation of Structures Life Prediction (CARES/LIFE) computer program. The program calculates the time-dependent reliability of monolithic ceramic components subjected to thermomechanical and/or proof test loading. CARES/LIFE is an extension of the CARES (Ceramic Analysis and Reliability Evaluation of Structures) computer program. The program uses results from MSC/NASTRAN, ABAQUS, and ANSYS finite element analysis programs to evaluate component reliability due to inherent surface and/or volume type flaws. CARES/LIFE accounts for the phenomenon of subcritical crack growth (SCG) by utilizing the power law, Paris law, or Walker law. The two-parameter Weibull cumulative distribution function is used to characterize the variation in component strength. The effects of multiaxial stresses are modeled by using either the principle of independent action (PIA), the Weibull normal stress averaging method (NSA), or the Batdorf theory. Inert strength and fatigue parameters are estimated from rupture strength data of naturally flawed specimens loaded in static, dynamic, or cyclic fatigue. The probabilistic time-dependent theories used in CARES/LIFE, along with the input and output for CARES/LIFE, are described. Example problems to demonstrate various features of the program are also included.
Manca, Donna Patricia; Aubrey-Bassler, Kris; Kandola, Kami; Aguilar, Carolina; Campbell-Scherer, Denise; Sopcak, Nicolette; O’Brien, Mary Ann; Meaney, Christopher; Faria, Vee; Baxter, Julia; Moineddin, Rahim; Salvalaggio, Ginetta; Green, Lee; Cave, Andrew; Grunfeld, Eva
Background The objectives of this paper are to describe the planned implementation and evaluation of the Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care (BETTER 2) program which originated from the BETTER trial. The pragmatic trial, informed by the Chronic Care Model, demonstrated the effectiveness of an approach to Chronic Disease Prevention and Screening (CDPS) involving the use of a new role, the prevention practitioner. The desired goals of t...
Gusikhin, Oleg; Madani, Kurosh; Sasiadek, Jurek
The present book includes a set of selected extended papers from the 11th International Conference on Informatics in Control, Automation and Robotics (ICINCO 2014), held in Vienna, Austria, from 1 to 3 September 2014. The conference brought together researchers, engineers and practitioners interested in the application of informatics to Control, Automation and Robotics. Four simultaneous tracks will be held, covering Intelligent Control Systems, Optimization, Robotics, Automation, Signal Processing, Sensors, Systems Modelling and Control, and Industrial Engineering, Production and Management. Informatics applications are pervasive in many areas of Control, Automation and Robotics. ICINCO 2014 received 301 submissions, from 49 countries, in all continents. After a double blind paper review performed by the Program Committee, 20% were accepted as full papers and thus selected for oral presentation. Additional papers were accepted as short papers and posters. A further selection was made after the Conference, ba...
Madani, Kurosh; Gusikhin, Oleg; Sasiadek, Jurek
The present book includes a set of selected extended papers from the 12th International Conference on Informatics in Control, Automation and Robotics (ICINCO 2015), held in Colmar, France, from 21 to 23 July 2015. The conference brought together researchers, engineers and practitioners interested in the application of informatics to Control, Automation and Robotics. Four simultaneous tracks will be held, covering Intelligent Control Systems, Optimization, Robotics, Automation, Signal Processing, Sensors, Systems Modelling and Control, and Industrial Engineering, Production and Management. Informatics applications are pervasive in many areas of Control, Automation and Robotics. ICINCO 2015 received 214 submissions, from 42 countries, in all continents. After a double blind paper review performed by the Program Committee, 14% were accepted as full papers and thus selected for oral presentation. Additional papers were accepted as short papers and posters. A further selection was made after the Conference, based ...
France is not advanced regarding evaluation in social work, despite a law established in January 2002 making evaluation a legal obligation every 5 years. This article presents a software program to help social services evaluate on both individual and group levels. Automatic dashboard results of the program with special emphasis on the main…
U.S. Department of Health & Human Services — The Federal Interagency Traumatic Brain Injury Research (FITBIR) informatics system is an extensible, scalable informatics platform for TBI relevant imaging,...
Full Text Available Recent advances in automated high-resolution fluorescence microscopy and robotic handling have made the systematic and cost effective study of diverse morphological changes within a large population of cells possible under a variety of perturbations, e.g., drugs, compounds, metal catalysts, RNA interference (RNAi. Cell population-based studies deviate from conventional microscopy studies on a few cells, and could provide stronger statistical power for drawing experimental observations and conclusions. However, it is challenging to manually extract and quantify phenotypic changes from the large amounts of complex image data generated. Thus, bioimage informatics approaches are needed to rapidly and objectively quantify and analyze the image data. This paper provides an overview of the bioimage informatics challenges and approaches in image-based studies for drug and target discovery. The concepts and capabilities of image-based screening are first illustrated by a few practical examples investigating different kinds of phenotypic changes caEditorsused by drugs, compounds, or RNAi. The bioimage analysis approaches, including object detection, segmentation, and tracking, are then described. Subsequently, the quantitative features, phenotype identification, and multidimensional profile analysis for profiling the effects of drugs and targets are summarized. Moreover, a number of publicly available software packages for bioimage informatics are listed for further reference. It is expected that this review will help readers, including those without bioimage informatics expertise, understand the capabilities, approaches, and tools of bioimage informatics and apply them to advance their own studies.
... memorandums are available on the FNS Web site at http://www.fns.usda.gov/cnd/Care/Regs-Policy/Policy/Memoranda....gov/cnd/care/Management/79-2.pdf . Finally, after publishing each of the interim rules, the...
Looney, Andrea L; Bohling, Mark W; Bushby, Philip A; Howe, Lisa M; Griffin, Brenda; Levy, Julie K; Eddlestone, Susan M; Weedon, James R; Appel, Leslie D; Rigdon-Brestle, Y Karla; Ferguson, Nancy J; Sweeney, David J; Tyson, Kathy A; Voors, Adriana H; White, Sara C; Wilford, Christine L; Farrell, Kelly A; Jefferson, Ellen P; Moyer, Michael R; Newbury, Sandra P; Saxton, Melissa A; Scarlett, Janet M
As efforts to reduce the overpopulation and euthanasia of unwanted and unowned dogs and cats have increased, greater attention has been focused on spay-neuter programs throughout the United States. Because of the wide range of geographic and demographic needs, a wide variety of programs have been developed to increase delivery of spay-neuter services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, feral cat programs, and services provided through private practitioners. In an effort to ensure a consistent level of care, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. The guidelines consist of recommendations for preoperative care (eg, patient transport and housing, patient selection, client communication, record keeping, and medical considerations), anesthetic management (eg, equipment, monitoring, perioperative considerations, anesthetic protocols, and emergency preparedness), surgical care (eg, operating-area environment; surgical-pack preparation; patient preparation; surgeon preparation; surgical procedures for pediatric, juvenile, and adult patients; and identification of neutered animals), and postoperative care (eg, analgesia, recovery, and release). These guidelines are based on current principles of anesthesiology, critical care medicine, microbiology, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs.
Khan-Mayberry, Noreen; Bassett, Stephanie
This slide presentation reviews the work of the Animal Care Program (ACP). Animals have been used early in space exploration to ascertain if it were possible to launch a manned spacecraft. The program is currently involved in many studies that assist in enhancing the scientific knowledge of the effect of space travel. The responsibilities of the ACP are: (1) Organize and supervise animal care operations & activities (research, testing & demonstration). (2) Maintain full accreditation by the International Association for the Assessment and Accreditation of Laboratory Animal Care (AAALAC) (3) Ensure protocol compliance with IACUC recommendations (4) Training astronauts for in-flight animal experiments (5) Maintain accurate & timely records for all animal research testing approved by JSC IACUC (6) Organize IACUC meetings and assist IACUC members (7) Coordinate IACUC review of the Institutional Program for Humane Care and Use of Animals (every 6 mos)
van Wilgen, C.P.; Bloten, H.; Oeseburg, B.
Purpose. Fibromyalgia is a syndrome of unknown origin with a high prevalence. Multimodal approaches seem to be the treatment of choice in fibromyalgia. A multidisciplinary program was developed and implemented for patients with fibromyalgia in the primary care setting. The program included education
Nouwens, E.; Lieshout, J. van; Wensing, M.
BACKGROUND: Practice accreditation is a widely used method to assess and improve the quality of healthcare services. In the Netherlands, a practice accreditation program was implemented in primary medical care. We aimed to identify determinants of impact of a practice accreditation program, building
Responses from 132 baccalaureate nursing programs indicated that the majority include spiritual dimensions in program philosophy and curriculum, but few had definitions of spirituality and nursing care. Content typically addressed patients' spiritual needs, dying, and holism. Respondents were uncertain about faculty preparation to teach about…
... Section 250.61 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS AND POLICIES-FOOD DISTRIBUTION DONATION OF FOODS... National School Lunch Program (NSLP) and Other Child Nutrition Programs § 250.61 Child and Adult Care...
Busboom, Jan R.; Newman, Jerry A.; Shulaw, William P.; Jeffreys, J. Bradford
This curriculum guide contains a six-unit, two-level program combining animal science and veterinary care for youth club leaders and members in grades three through twelve. The Facilitator and Educator/Leader Introductions describe the program, the goals, and the students who will participate. The six lesson plans contain what the lesson is about,…
"Loyalty rewards" in sponsored DM and HRM programs can apply to both providers and consumers. Physicians and hospitals can be paid to "loyally" adhere to payers' guidelines for managing diseases and risks. Many payer and their outsourced vendor programs include significant efforts to create collaborations between payer and provider, rather than relying on unilateral efforts. And growing numbers are rewarding providers for their efforts and results achieved.
James M Lightwood
Full Text Available BACKGROUND: Large state tobacco control programs have been shown to reduce smoking and would be expected to affect health care costs. We investigate the effect of California's large-scale tobacco control program on aggregate personal health care expenditures in the state. METHODS AND FINDINGS: Cointegrating regressions were used to predict (1 the difference in per capita cigarette consumption between California and 38 control states as a function of the difference in cumulative expenditures of the California and control state tobacco control programs, and (2 the relationship between the difference in cigarette consumption and the difference in per capita personal health expenditures between the control states and California between 1980 and 2004. Between 1989 (when it started and 2004, the California program was associated with $86 billion (2004 US dollars (95% confidence interval [CI] $28 billion to $151 billion lower health care expenditures than would have been expected without the program. This reduction grew over time, reaching 7.3% (95% CI 2.7%-12.1% of total health care expenditures in 2004. CONCLUSIONS: A strong tobacco control program is not only associated with reduced smoking, but also with reductions in health care expenditures.
Francisco J. Ramos-Gomez
Full Text Available The Affordable Care Act (ACA mandates risk assessments, preventive care, and evaluations based on outcomes. ACA compliance will require easily accessible, cost-effective care models that are flexible and simple to establish. UCLA has developed an Infant Oral Care Program (IOCP in partnership with community-based organizations that is an intervention model providing culturally competent perinatal and infant oral care for underserved, low-income, and/or minority children aged 0–5 and their caregivers. In collaboration with the Venice Family Clinic's Simms/Mann Health and Wellness Center, UCLA Pediatrics, Women, Infants, and Children (WIC, and Early Head Start and Head Start programs, the IOCP increases family-centered care access and promotes early utilization of dental services in nontraditional, primary care settings. Emphasizing disease prevention, management, and care that is sensitive to cultural, language, and oral health literacy challenges, IOCP patients achieve better oral health maintenance “in health” not in “disease modality”. IOCP uses interprofessional education to promote pediatric oral health across multiple disciplines and highlights the necessity for the “age-one visit”. This innovative clinical model facilitates early intervention and disease management. It sets a new standard of minimally invasive dental care that is widely available and prevention focused, with high retention rates due to strong collaborations with the community-based organizations serving these vulnerable, high-risk children.
Edwards, Scott J; Abbott, Rick; Edwards, Jonathan; LeBlanc, Michael; Dranitsaris, George; Donnan, Jennifer; Laing, Kara; Whelan, Maria A; MacKinnon, Neil J
The primary goal of seamless care is improved patient outcomes and improved standards of care for patients with cancer. The pharmacy service of the Newfoundland Cancer Treatment and Research Foundation conducted a randomized control study that measured clinical and humanistic outcomes of a pharmacist-directed seamless care program in an ambulatory oncology clinic. This article focuses on the intervention group, particularly the identification of drug-related problems (DRPs) and utilization of health care services as well the satisfaction of 3 types of health professionals with the services provided by the pharmacist-directed seamless care program. Overall, the seamless care pharmacist (SCP) identified an average of 3.7 DRPs per intervention patient; the most common DRP reported was a patient not receiving or taking a drug therapy for which there is an indication. The SCP identified more DRPs in patients receiving adjuvant treatment compared to those receiving palliative treatment. On average, family physicians, oncology nurses, and hospital pharmacists were satisfied with the SCP intervention indicating that they agreed the information collected and distributed by the SCP was useful to them. Pharmacist-directed seamless care services in an ambulatory oncology clinic have a significant impact on clinical outcomes and processes of patient care. The presence of a SCP can help identify and resolve DRPs experienced by patients in an outpatient oncology clinic, ensuring that patients are receiving the highest standard of care.
concentrations of biochemical substrates and associated increased gluconeogene- sis and skeletal muscle nitrogen release. There is also a failure to...have been inserted in the hepatic, portal, and mesenteric veins, and in the renal vein. In one study, catheters were carefully placed in the lower aorta...the sheep and dog . American Journal of Physiology 216:946-952, 1969. 3. Katz, M.L., Bergman, E.W.: A method for simultaneous cannulation of the major
Rucker, Bronwyn; Browning, David M
A Physician Communication Training Program (PCTP) utilizing scripts based on actual family conferences with patients, families, and the health care team was developed at one medical center in the Northeast. The program was designed, adapted, and directed by a palliative care social worker. The primary goal of the program is to help residents and attending physicians build better communication skills in establishing goals of care and in end-of-life planning. The scripts focus on improving physicians' basic skills in conducting family meetings, discussing advance directives, prognosis, brain death, and withdrawal of life support. Excerpts from the scripts utilized in the program are included. Feedback from participants has been positive, with all respondents indicating improvement in their capacity to take part in these challenging conversations.
Full Text Available Kelly Warmington,1 Carol A Kennedy,2 Katie Lundon,3 Leslie J Soever,4 Sydney C Brooks,5 Laura A Passalent,6 Rachel Shupak,7 Rayfel Schneider,8 1Learning Institute, Hospital for Sick Children, 2Musculoskeletal Health and Outcomes Research, St Michael’s Hospital, 3Continuing Professional Development, Faculty of Medicine, University of Toronto, 4University Health Network, 5Ontario Division, Arthritis Society, 6Toronto Western Hospital, 7Division of Rheumatology, St Michael's Hospital, 8Division of Rheumatology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada Objective: To assess patient satisfaction with the arthritis care services provided by graduates of the Advanced Clinician Practitioner in Arthritis Care (ACPAC program. Materials and methods: This was a cross-sectional evaluation using a self-report questionnaire for data collection. Participants completed the Patient–Doctor Interaction Scale, modified to capture patient–practitioner interactions. Participants completed selected items from the Group Health Association of America's Consumer Satisfaction Survey, and items capturing quality of care, appropriateness of wait times, and a comparison of extended-role practitioner (ERP services with previously received arthritis care. Results: A total of 325 patients seen by 27 ERPs from 15 institutions completed the questionnaire. Respondents were primarily adults (85%, female (72%, and living in urban areas (79%. The mean age of participants was 54 years (range 3–92 years, and 51% were not working. Patients with inflammatory (51% and noninflammatory conditions (31% were represented. Mean (standard deviation Patient–Practitioner Interaction Scale subscale scores ranged from 4.50 (0.60 to 4.63 (0.48 (1 to 5 [greater satisfaction]. Overall satisfaction with the quality of care was high (4.39 [0.77], as was satisfaction with wait times (referral to appointment, 4.27 [0.86]; in clinic, 4.24 [0.91]. Ninety-eight percent of
Full Text Available Background: The chronic care model provides a framework for improving the management of chronic diseases. Participatory research could be useful in developing a chronic care model–based program of interventions, but no one has as yet offered a description of precisely how to apply the approach. Objectives: An innovative, structured, multi-step participatory process was applied to select and develop (1 chronic care model–based interventions program to improve cardiovascular disease prevention that can be adapted to a particular regional context and (2 a set of indicators to monitor its implementation. Methods: Primary care clinicians (n = 16, administrative staff (n = 2, patients and family members (n = 4, decision makers (n = 5, researchers, and a research coordinator (n = 7 took part in the process. Additional primary care actors (n = 26 validated the program. Results: The program targets multimorbid patients at high or moderate risk of cardiovascular disease with uncontrolled hypertension, dyslipidemia or diabetes. It comprises interprofessional follow-up coordinated by case-management nurses, in which motivated patients are referred in a timely fashion to appropriate clinical and community resources. The program is supported by clinical tools and includes training in motivational interviewing. A set of 89 process and clinical indicators were defined. Conclusion: Through a participatory process, a contextualized interventions program to optimize cardiovascular disease prevention and a set of quality indicators to monitor its implementation were developed. Similar approach might be used to develop other health programs in primary care if program developers are open to building on community strengths and priorities.
... [CMS-2480-NC] Medicaid Program; Request for Comments on Legislative Changes To Provide Quality of Care... recommendations for legislative changes to improve the quality of care provided to children under Medicaid and the... quality of care provided to children under Medicaid and the Children's Health Insurance Program....
Full Text Available Geophysics is based on massive data work including data observation, data gathering/collecting, data management, and data analysis. Over the years, in China and other countries, geophysicists and geophysical institutions have accumulated a huge amount of geophysical data, built up many geophysical data banks and data centers, constructed/established many monitoring and transferring systems and infrastructures of geophysical data, and developed many advanced data analysis methods about data on land, ocean, and space. Based on this work, a new discipline of geophysics, geophysical informatics, has been gradually developing over the past 20 years. The recent advances of geophysical informatics in China are introduced and reviewed in this paper.
Pardalos, Panos M; Xanthopoulos, Petros
This volume covers some of the topics that are related to the rapidly growing field of biomedical informatics. In June 11-12, 2010 a workshop entitled 'Optimization and Data Analysis in Biomedical Informatics' was organized at The Fields Institute. Following this event invited contributions were gathered based on the talks presented at the workshop, and additional invited chapters were chosen from world's leading experts. In this publication, the authors share their expertise in the form of state-of-the-art research and review chapters, bringing together researchers from different disciplines
Reyes, H Luz McNaughton; Zuniga, Karen Padilla; Billings, Deborah L; Blandon, Marta Maria
Health care providers play a central role in the promotion and protection of human rights in patient care. Consequently, the World Medical Association, among others, has called on medical and nursing schools to incorporate human rights education into their training programs. This report describes the efforts of one Central American nongovernmental organization to include human rights - related content into reproductive health care provider training programs in Nicaragua and El Salvador. Baseline findings suggest that health care providers are not being adequately prepared to fulfill their duty to protect and promote human rights in patient care. Medical and nursing school administrators, faculty, and students recognize the need to strengthen training in this area and are enthusiastic about incorporating human rights content into their education programs. Evaluation findings suggest that exposure to educational materials and methodologies that emphasize the relationship between human rights and reproductive health may lead to changes in health care provider attitudes and behaviors that help promote and safeguard human rights in patient care.
Goodly, Lyndon J; Jarrell, Vickie L; Miller, Monica A; Banks, Maureen C; Anderson, Thomas J; Branson, Katherine A; Woodward, Robert T; Peper, Randall L; Myers, Sara J
The Public Health Service Policy on the Humane Care and Use of Laboratory Animals and sound ethical practices require institutions to provide safe working environments for personnel working with animals; this mandate is achieved in part by establishing an effective animal care Occupational Health and Safety Program (OHSP). Land-grant institutions often face unique organizational challenges in fulfilling this requirement. For example, responsibilities for providing health and safety programs often have historically been dispersed among many different divisions scattered around the campus. Here we describe how our institutional management personnel overcame organizational structure and cultural obstacles during the formation of a comprehensive campus-wide animal care OHSP. Steps toward establishing the animal care OHSP included assigning overall responsibility, identifying all stakeholders, creating a leadership group, and hiring a fulltime Animal Care OHSP Specialist. A web-based portal was developed, implemented, and refined over the past 7 y and reflected the unique organizational structures of the university and the needs of our research community. Through this web-based portal, hazards are identified, risks are assessed, and training is provided. The animal care OHSP now provides easy mandatory enrollment, supports timely feedback regarding hazards, and affords enrollees the opportunity to participate in voluntary medical surveillance. The future direction and development of the animal care OHSP will be based on the research trends of campus, identification of emerging health and safety hazards, and ongoing evaluation and refinement of the program.
Koch, Edward F
The VA Maryland Health Care System introduced videoconferencing technology to provide psychiatry, evidenced-based psychotherapy, case management, and patient education at rural clinics where it was difficult to recruit providers. Telemental health services enable rural clinics to offer additional services, such as case management and patient education. Services have been expanded to urban outpatient clinics where a limited number of mental health clinic hours are available. This technology expands the availability of mental health providers and services, allowing patients to receive services from providers located at distant medical centers.
... affect in a material way the economy, a sector of the economy, productivity, competition, jobs, the... facilities have been ascertained to VA's satisfaction, and then only to applicants determined by VA to meet... policies and procedures of the program. There will be at a minimum, an employee on duty on the premises,...
... to the satisfaction of the resident, working with the resident to assure his or her well-being. In... life at the local, state and national levels. Begun in 1972 as a demonstration program, Ombudsman... and rights as well as to provide the resident with the option to consent to disclosure of...
Kerssens, J.J.; Sluijs, E.M.; Verhaak, P.F.M.; Knibbe, H.J.J.; Hermans, I.M.J.
Background and Purpose: The treatment of people with low back pain often includes giving a variety of instructions about back care. The objective of our study was to explore the content and sequence of these instructions. Subjects: Our database contained information on 1,151 therapy sessions for 132
Full Text Available BACKGROUND: Effective methods of secondary prevention after stroke or TIA are available but adherence to recommended evidence-based treatments is often poor. The study aimed to determine the quality of secondary prevention in usual care and to develop a stepwise modeled support program. METHODS: Two consecutive cohorts of patients with acute minor stroke or TIA undergoing usual outpatient care versus a secondary prevention program were compared. Risk factor control and medication adherence were assessed in 6-month follow-ups (6M-FU. Usual care consisted of detailed information concerning vascular risk factor targets given at discharge and regular outpatient care by primary care physicians. The stepwise modeled support program additionally employed up to four outpatient appointments. A combination of educational and behavioral strategies was employed. RESULTS: 168 patients in the observational cohort who stated their openness to participate in a prevention program (mean age 64.7 y, admission blood pressure (BP: 155/84 mmHg and 173 patients participating in the support program (mean age 67.6 y, BP: 161/84 mmHg were assessed at 6 months. Proportions of patients with BP according to guidelines were 50% in usual-care and 77% in the support program (p<0.01. LDL<100 mg/dl was measured in 62 versus 71% (p = 0.12. Proportions of patients who stopped smoking were 50 versus 79% (p<0.01. 72 versus 89% of patients with atrial fibrillation were on oral anticoagulation (p = 0.09. CONCLUSIONS: Risk factor control remains unsatisfactory in usual care. Targets of secondary prevention were met more often within the supported cohort. Effects on (cerebro-vascular recurrence rates are going to be assessed in a multicenter randomized trial.
Nikolay Vasilyevich Lukashov
Full Text Available Objective to show that the informatization of state and municipal governance in modern Russia should be aimed directly at reducing costs and improving productivity of the state and municipal authorities and not at the achievement of indirect performance indicators like ldquothe proportion of documents in digital formquot. Methods the method of analysis of the research object condition at various stages of its development the synthesis of cognition elements followed by synthesis and transition from the singular to the general. General scientific specific and private scientific research methods were used. Results basing on the analysis of informatization of state and municipal management it is shown that the main reason for its low efficiency is the current evaluation system based on indirect indicators. Scientific novelty the efficiency and effectiveness of informatization of state and municipal management are considered from the point of view of consistency and optimal allocation of resources. The scientific justification of performance indicators of informatization in the sphere of state and municipal management is proposed which is characterized by the blurring of the quality criteria difficult to express in monetary terms. Examples of such criteria are cost of rendering of state municipal services physical geographical by mode of operation by convenience accessibility of services time of waiting in queue and length of obtaining the service by a citizen regardless of in which form traditional or digital it is rendered. Practical value the article considers the problems of selecting the efficiency criteria of social control informatization. Specific measures are proposed aimed at improving the efficiency of informatization including in the framework of realization of the Federal program of the Russian Federation quotInformational societyquot for 20122020. nbsp
Augustin, M; Eissing, L; Langenbruch, A; Enk, A; Luger, T; Maaßen, D; Mrowietz, U; Reich, K; Reusch, M; Strömer, K; Thaçi, D; von Kiedrowski, R; Radtke, M A
In 2005, the first national psoriasis survey in Germany revealed large deficits in health care particularly in patients with moderate to severe disease. The consecutive goal was to improve health care for psoriasis countrywide. For this, a large-scale national program was initiated starting with a comprehensive analysis of structures and processes of care for psoriasis. Patient burden, economic impact and barriers to care were systematically analyzed. In order to optimize routine care, a S3 guideline, a set of outcomes measures and treatment goals, were developed. Implementation was enforced by the German Psoriasis Networks (PsoNet) connecting the most dedicated dermatologists. The annual National Conference on Health Care in Psoriasis established in 2009 consented National Health Care Goals in Psoriasis 2010-2015 and defined a set of quality indicators, which are monitored on a regular basis. Currently 28 regional networks including more than 800 dermatologists are active. Between 2005 and 2014 7 out of 8 quality indicators have markedly improved, and regional disparities were resolved. e.g., mean PASI (Psoriasis Area Severity Index) dropped from 11.4 to 8.1 and DLQI (Dermatology Life Quality Index) from 8.6 to 5.9. A decade of experience indicates that a coordinated nationwide psoriasis program based on goal orientation can contribute to better quality of care and optimized outcomes.
Michelson, Kelly Nicole; Blehart, Kathleen; Hochberg, Todd; James, Kristin
Reports of in-hospital bereavement photography focus largely on stillborns and neonates. Empiric data regarding the implementation of bereavement photography in pediatrics beyond the neonatal period and the impact of such programs on healthcare professionals (HCPs) is lacking. The authors describe the implementation of a pediatric intensive care unit (PICU) bereavement photography program and use questionnaire data from HCPs to describe HCPs' reflections on the program and to identify program barriers. From July 2007 through April 2070, families of 59 (36%) of the 164 patients who died in the PICU participated in our bereavement photography program. Forty questionnaires from 29 HCPs caring for 39 participating patients/families indicated that families seemed grateful for the service (n = 34; 85%) and that the program helped HCPs feel better about their role (n = 30; 70%). Many HCPs disagreed that the program consumed too much of his/her time (n = 34; 85%) and that the photographer made his/her job difficult (n = 37; 92.5%). Qualitative analysis of responses to open-ended questions revealed 4 categories: the program's general value; positive aspects of the program; negative aspects of the program; and suggestions for improvements. Implementing bereavement photography in the PICU is feasible though some barriers exist. HCPs may benefit from such programs.
Ramos, Luiz Roberto; Malta, Deborah Carvalho; Gomes, Grace Angélica de Oliveira; Bracco, Mário M; Florindo, Alex Antonio; Mielke, Gregore Iven; Parra, Diana C; Lobelo, Felipe; Simoes, Eduardo J; Hallal, Pedro Curi
OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil. PMID:25372175
European medical informatics professionals traditionally gather at congresses of the European Federation for Medical Informatics (EFMI) named "Medical Informatics Europe - MIE". After more than three decades of successive organization of these congresses, some important points of their history of are presented. As the MIE Congress in Sarajevo, organized by the Society for Medical Informatics of Bosnia and Herzegovina (BHSMI), is the third EFMI event in the western part of South-East Europe, a short review of the development of medical informatics in this part of Europe, together with important events in its history, will shortly be presented.
Full Text Available Presented paper deals with analysis and identification of business informatics specifics in agricultural enterprises in the Czech Republic farming at land of size up to 500 hectares. The study is based on thorough review of literature about latest issues in agriculture business informatics. There is a follow up to certain results of previous research on business informatics in agriculture that was conducted by authors in 2013. The analysis has brought findings that business informatics has several peculiarities that must be regarded in informatics implementation and innovation. Those are common economic and organisational effects and further aspects typical for the agriculture such as climate, local conditions and seasonal nature of production.
Alyeshmerni, Daniel; Froehlich, James B; Lewin, Jack; Eagle, Kim A
Despite its status as a world leader in treatment innovation and medical education, a quality chasm exists in American health care. Care fragmentation and poor coordination contribute to expensive care with highly variable quality in the United States. The rising costs of health care since 1990 have had a huge impact on individuals, families, businesses, the federal and state governments, and the national budget deficit. The passage of the Affordable Care Act represents a large shift in how health care is financed and delivered in the United States. The objective of this review is to describe some of the economic and social forces driving health care reform, provide an overview of the Patient Protection and Affordable Care Act (ACA), and review model cardiovascular quality improvement programs underway in the state of Michigan. As health care reorganization occurs at the federal level, local and regional efforts can serve as models to accelerate improvement toward achieving better population health and better care at lower cost. Model programs in Michigan have achieved this goal in cardiovascular care through the systematic application of evidence-based care, the utilization of regional quality improvement collaboratives, community-based childhood wellness promotion, and medical device-based competitive bidding strategies. These efforts are examples of the direction cardiovascular care delivery will need to move in this era of the Affordable Care Act.
Full Text Available Despite its status as a world leader in treatment innovation and medical education, a quality chasm exists in American health care. Care fragmentation and poor coordination contribute to expensive care with highly variable quality in the United States. The rising costs of health care since 1990 have had a huge impact on individuals, families, businesses, the federal and state governments, and the national budget deficit. The passage of the Affordable Care Act represents a large shift in how health care is financed and delivered in the United States. The objective of this review is to describe some of the economic and social forces driving health care reform, provide an overview of the Patient Protection and Affordable Care Act (ACA, and review model cardiovascular quality improvement programs underway in the state of Michigan. As health care reorganization occurs at the federal level, local and regional efforts can serve as models to accelerate improvement toward achieving better population health and better care at lower cost. Model programs in Michigan have achieved this goal in cardiovascular care through the systematic application of evidence-based care, the utilization of regional quality improvement collaboratives, community-based childhood wellness promotion, and medical device-based competitive bidding strategies. These efforts are examples of the direction cardiovascular care delivery will need to move in this era of the Affordable Care Act.
Smith, Lauren E; Flanders, Sonya A
This article discusses the history of the Comprehensive Unit-based Safety Program (CUSP) and how it is used to foster a culture of safety. CUSP involves interdisciplinary teamwork and empowers nurses at all levels to pioneer changes and develop leadership skills. A case study is presented to show how CUSP was used effectively in critical care to create a standardized handover of patients from the operating room to the intensive care unit.
Pérez-Cuevas, R; Reyes, H; Guiscafré, H; Juárez-Díaz, N; Oviedo, M; Flores, S; Muñoz, O
The Mexican Institute of Social Security (IMSS) is Mexico's Largest state-financed health care system, providing care to 50 million people. This system comprises 1450 family medicine clinics staffed by 14,000 family physicians, as well as 240 secondary care hospitals and 10 tertiary care medical centres. We developed a program of continuing medical education (CME) for IMSS family physicians. The program had 4 stages, which were completed over a 7-month period: development of clinical guidelines, training of clinical instructors, an educational intervention (consisting of interactive workshops, individual tutorials and peer group sessions), and evaluation of both physicians' performance and patients' health status. The pilot study was conducted in an IMSS family medicine clinic providing care to 45,000 people; 20 family physicians and 4 clinical instructors participated. The 2 main reasons for visits to IMSS family medicine clinics are acute respiratory infections and type 2 diabetes mellitus. Therefore, patients being treated at the clinic for either of these illnesses were included in the study. The sources of data were interviews with physicians and patients, clinical records and written prescriptions. A 1-group pretest-posttest design was used to compare physicians' performance in treating the 2 illnesses of interest. We found that the daily activities of the clinic could be reorganized to accommodate the CME program and that usual provision of health care services was maintained. Physicians accepted and participated actively in the program, and their performance improved over the course of the study. We conclude that this CME strategy is feasible, is acceptable to family physicians and may improve the quality of health care provided at IMSS primary care facilities. The effectiveness and sustainability of the strategy should be measured through an evaluative study.
Roy-Chowdhuri, Sinchita; Roy, Somak; Monaco, Sara E; Routbort, Mark J; Pantanowitz, Liron
The rapid adoption of next-generation sequencing (NGS) in clinical molecular laboratories has redefined the practice of cytopathology. Instead of simply being used as a diagnostic tool, cytopathology has evolved into a practice providing important genomic information that guides clinical management. The recent emphasis on maximizing limited-volume cytology samples for ancillary molecular studies, including NGS, requires cytopathologists not only to be more involved in specimen collection and processing techniques but also to be aware of downstream testing and informatics issues. For the integration of molecular informatics into the clinical workflow, it is important to understand the computational components of the NGS workflow by which raw sequence data are transformed into clinically actionable genomic information and to address the challenges of having a robust and sustainable informatics infrastructure for NGS-based testing in a clinical environment. Adapting to needs ranging from specimen procurement to report delivery is crucial for the optimal utilization of cytology specimens to accommodate requests from clinicians to improve patient care. This review presents a broad overview of the various aspects of informatics in the context of NGS-based testing of cytology specimens. Cancer Cytopathol 2016. © 2016 American Cancer Society.
Current status of rural informatization construction in China,including the relatively weak rural informatization,asymmetric market information,low level of information sharing,dispersedly allocated resources and no cross point among each other are analyzed.The importance of informatization in rural logistic system is introduced:firstly,decision making of logistics system plan is based on information.Secondly,improvement of the overall efficiency of logistics system is based on information.Thirdly,logistics transmission takes the Internet as the carrier.Necessity of rural logistics system is discussed from five aspects of increasing the employment of farmers,enhancing the income of farmers,reducing the blindness of agricultural production and circulation,sharing the risks of agricultural management,and promoting the rural economic restructuring.According to the above five steps,five countermeasures are posed in order to improve the rural logistics system.The countermeasures cover the aspects of deepening the information awareness of government,establishing a rural informatization system suited to the national condition of China,strengthening the information infrastructure in rural areas,promoting the integration of rural information resources and establishing the training system for agricultural information talents.
@@ This paper presents the working procedure of power generating enterprises and explains the framework of an e-power-plant and its information system, puts forward the guideline and the general goal of informatization construction while focusing on the construction goal in the applied system, the implementing strategy, the project management and organization.
Patel, Vimla L; Kannampallil, Thomas G
Cognitive Informatics (CI) is a burgeoning interdisciplinary domain comprising of the cognitive and information sciences that focuses on human information processing, mechanisms and processes within the context of computing and computer applications. Based on a review of articles published in the Journal of Biomedical Informatics (JBI) between January 2001 and March 2014, we identified 57 articles that focused on topics related to cognitive informatics. We found that while the acceptance of CI into the mainstream informatics research literature is relatively recent, its impact has been significant - from characterizing the limits of clinician problem-solving and reasoning behavior, to describing coordination and communication patterns of distributed clinical teams, to developing sustainable and cognitively-plausible interventions for supporting clinician activities. Additionally, we found that most research contributions fell under the topics of decision-making, usability and distributed team activities with a focus on studying behavioral and cognitive aspects of clinical personnel, as they performed their activities or interacted with health information systems. We summarize our findings within the context of the current areas of CI research, future research directions and current and future challenges for CI researchers.
The purpose of the International Conference on Health Informatics is to bring together researchers and practitioners interested in the application of information and communication technologies (ICT) to healthcare and medicine in general and to the support of persons with special needs in particular.
Reid, Paulette; Borycki, Elizabeth M
Healthcare consumers are increasingly seeking reliable forms of health information on the Internet that can be used to support health related decision-making. Frameworks that have been developed and tested in the field of health informatics have attempted to describe the effects of the Internet upon the health care consumer and physician relationship. More recently, health care organizations are responding by providing information such as hospital wait lists or strategies for self-managing disease, and this information is being provided on organizational web-sites. The authors of this paper propose that current conceptualizations of the relationship between the Internet, physicians and patients are limited from a consumer informatics perspective and may need to be extended to include healthcare organizations.
Lawlis, Tanya; Wicks, Alison; Jamieson, Maggie; Haughey, Amy; Grealish, Laurie
Health professional clinical education is commonly conducted in single discipline modes, thus limiting student collaboration skills. Aged care residential facilities, due to the chronic and complex health care needs of residents, provide an ideal placement to provide a collaborative experience. Interprofessional education is widely acknowledged as the pedagogical framework through which to facilitate collaboration. The aim of the evaluation was to assess student attitudes towards collaboration after active involvement in an interprofessional education program. Students studying nursing, occupational therapy, and aged care were invited to complete a version of the Readiness for Interprofessional Learning Scale before and after participating in a three-week pilot interprofessional program. A positive change in student attitudes towards other health professionals and the importance of working in interprofessional teams was reported with significant differences between two statements indicated: Learning with health-care students before qualifications would improve relationships after qualifications; and I learned a lot from the students from the other disciplines. The innovative pilot project was found to enhance student learning in interprofessional teams and the aged care environment. Further development of this and similar interprofessional programs is required to develop sustainable student projects that have health benefits for residents in aged care residential facilities.
Stoller, James K
Effective leadership is critical for optimizing cost, access, and quality in health care. Creating a pipeline of effective health care leaders requires developing leadership competencies that differ from the usual criteria of clinical and scientific excellence by which physicians have traditionally been promoted to leadership positions. Specific competencies that differentiate effective leaders from average leaders, especially emotional intelligence and its component abilities, are essential for effective leadership.Adopting a long-standing practice from successful corporations, some health care institutions, medical societies, and business schools now offer leadership programs that address these differentiating leadership competencies. The author draws on experience with such programs through the Cleveland Clinic Academy to provide recommendations for health care leadership training and to identify unanswered questions about such programs.The author recommends that such training should be broadly available to all health care leadership communities (i.e., nurses, administrators, and physicians). A progressive curriculum, starting with foundational concepts and extending to coaching and feedback opportunities through experiential learning, recognizes the challenge of becoming an effective leader and the long time line needed to do so. Linking leadership courses to continuing medical education and to graduate credit opportunities is appealing to participants. Other recommendations focus on the importance of current leaders' involvement in nominating emerging leaders for participation, embedding leadership development discussions in faculty's professional reviews, and blending discussion of frameworks and theory with practical, experiential lessons. The author identifies questions about the benefits of formal health care leadership training that remain to be answered.
Yamauti, Sueli Miyuki; Barberato-Filho, Silvio; Lopes, Luciane Cruz
This study aimed to analyze the list of drugs in the Popular Pharmacy Program in Brazil (PFPB) in relation to the country's pharmaceutical care policy. The list of drugs in the PFPB was compared to the Brazilian and international reference lists of essential medicines, the components of pharmaceutical care in Brazilian Unified National Health System (SUS), and drug production by the country's government pharmaceutical laboratories. The PFPB list includes 119 drugs, of which 19.3% and 47.1% were not selected on the Brazilian and international reference lists, respectively; 16.8% are not used in primary care, and 40.3% are not produced by the country's government laboratories. A revision of the PFPB list based on the essential medicines concept (World Health Organization), alignment of pharmaceutical care policies, and production by government laboratories are essential to improve quality of health care, management, training of prescribers, and information for the population.
Dong, Xiao; Bahroos, Neil; Sadhu, Eugene; Jackson, Tommie; Chukhman, Morris; Johnson, Robert; Boyd, Andrew; Hynes, Denise
In this manuscript, we present our experiences using the Apache Hadoop framework for high data volume and computationally intensive applications, and discuss some best practice guidelines in a clinical informatics setting. There are three main aspects in our approach: (a) process and integrate diverse, heterogeneous data sources using standard Hadoop programming tools and customized MapReduce programs; (b) after fine-grained aggregate results are obtained, perform data analysis using the Mahout data mining library; (c) leverage the column oriented features in HBase for patient centric modeling and complex temporal reasoning. This framework provides a scalable solution to meet the rapidly increasing, imperative "Big Data" needs of clinical and translational research. The intrinsic advantage of fault tolerance, high availability and scalability of Hadoop platform makes these applications readily deployable at the enterprise level cluster environment.
Full Text Available As the role of traditional medicine in community health improvement increases, a comprehensive health care program for infectious diseases management in child-care centers by Korean medicine doctors was developed. The purpose of this study is to evaluate the effects of the program intervention on infection-related medical care utilization among children. The study used a quasi-experimental design with nonequivalent control group, comparing pre- and post-intervention data of the same children. The program implemented interventions in terms of management, education, and medical examination for the teachers, parents, and children in 12-week period. The frequency of utilization, cost, and prescription days of drugs and antibiotics due to infectious diseases prior to the intervention were compared with those during the 3-month intervention, using health insurance claim data. A panel analysis was also conducted to support the findings. A significant reduction (12% in infection-related visit days of hospitals was observed with the intervention (incident rate ratio = 0.88, P=0.01. And medical cost, drug prescription days, and antibiotics prescription days were decreased, although not statistically significant. A further cost-effectiveness analysis in terms of social perspectives, considering the opportunity costs for guardians to take children to medical institutions, would be needed.
Carey, Lindsay B; Hennequin, Christine; Krikheli, Lillian; O'Brien, Annette; Sanchez, Erin; Marsden, Candace R
Given declining populations in rural areas and diminishing traditional religious support, this research explores whether spiritual care education programs would be beneficial for and appreciated by those working in rural health and/or community organizations. An overview of literature identified three dominant rural health issues affecting the provision of spiritual care in rural areas, namely the disparity between rural and urban areas in terms of resources, the lack of access to services, plus the need for education and training within rural areas. Spiritual Health Victoria Incorporated (Victoria, Australia) sought to address these issues with the implementation of a variety of spiritual education programs within rural areas. Results of an evaluation of these programs are presented specifying participant demographics, reasons why participants attended, their evaluation of the program and any recommendations for future programs. In overall terms, the results indicated that at least 90% of participants favorably rated their attended program as either 'very good' or 'good' and indicated that the main reason for their attendance was to develop their own education and/or practice of spiritual care within their rural context for the benefit of local constituents. Several recommendations are made for future programs.
Molina Emilio Herrera
Full Text Available Abstract Background SAIATU is a program of specially trained in-home social assistance and companionship which, since February 2011, has provided support to end-of-life patients, enabling the delivery of better clinical care by healthcare professionals in Osakidetza (Basque Health Service, in Guipúzcoa (Autonomous Community of the Basque Country. In January 2012, a retrospective observational study was carried out, with the aim of describing the characteristics of the service and determining if the new social service and the associated socio-health co-ordination had produced any effect on the use of healthcare resources by end-of-life patients. The results of a comparison of a cohort of cases and controls demonstrated evidence that the program could reduce the use of hospital resources and promote the continuation of living at home, increasing the home-based activity of primary care professionals. The objective of this study is to analyse whether a program of social intervention in palliative care (SAIATU results in a reduction in the consumption of healthcare resources and cost by end-of-life patients and promotes a shift towards a more community-based model of care. Method/design Comparative prospective cohort study, with randomised selection of patients, which will systematically measure patient characteristics and their consumption of resources in the last 30 days of life, with and without the intervention of a social support team trained to provide in-home end-of-life care. For a sample of approximately 150 patients, data regarding the consumption of public healthcare resources, SAIATU activity, home hospitalisation teams, and palliative care will be recorded. Such data will also include information dealing with the socio-demographic and clinical characteristics of the patients and attending carers, as well as particular characteristics of patient outcomes (Karnofsky Index, and of the outcomes of palliative care received (Palliative
Ford, Channing R; Brown, Cynthia J; Sawyer, Patricia; Rothrock, Angela G; Ritchie, Christine S
To improve the health care of older adults, a faculty development program was created to enhance geriatric knowledge. The University of Alabama at Birmingham (UAB) Geriatric Education Center leadership instituted a one-year, 36-hour curriculum focusing on older adults with complex health care needs. Content areas were chosen from the Institute of Medicine Transforming Health Care Quality report and a local needs assessment. Potential preceptors were identified and participant recruitment efforts began by contacting UAB department chairs of health care disciplines. This article describes the development of the program and its implementation over three cohorts of faculty scholars (n = 41) representing 13 disciplines, from nine institutions of higher learning. Formative and summative evaluation showed program success in terms of positive faculty reports of the program, information gained, and expressed intent by each scholar to apply learned content to teaching and/or clinical practice. This article describes the initial framework and strategies guiding the development of a thriving interprofessional geriatric education program.
Big data are receiving an increasing attention in biomedicine and healthcare. It is therefore important to understand the reason why big data are assuming a crucial role for the biomedical informatics community. The capability of handling big data is becoming an enabler to carry out unprecedented research studies and to implement new models of healthcare delivery. Therefore, it is first necessary to deeply understand the four elements that constitute big data, namely Volume, Variety, Velocity, and Veracity, and their meaning in practice. Then, it is mandatory to understand where big data are present, and where they can be beneficially collected. There are research fields, such as translational bioinformatics, which need to rely on big data technologies to withstand the shock wave of data that is generated every day. Other areas, ranging from epidemiology to clinical care, can benefit from the exploitation of the large amounts of data that are nowadays available, from personal monitoring to primary care. However, building big data-enabled systems carries on relevant implications in terms of reproducibility of research studies and management of privacy and data access; proper actions should be taken to deal with these issues. An interesting consequence of the big data scenario is the availability of new software, methods, and tools, such as map-reduce, cloud computing, and concept drift machine learning algorithms, which will not only contribute to big data research, but may be beneficial in many biomedical informatics applications. The way forward with the big data opportunity will require properly applied engineering principles to design studies and applications, to avoid preconceptions or over-enthusiasms, to fully exploit the available technologies, and to improve data processing and data management regulations.
Full Text Available Background: To develop and implement more effective programs of health care delivery to prevent and control diabetes, Iran has developed and implemented the urban phase of the specialized care program for diabetic′s patients. Deeply understanding the views and experiences of various stakeholders in this program can assist policy makers to identify the program′s strengths and weaknesses and enable them to develop action plans. Hence, the present study aimed to evaluate the planning and establishing of this program from the perspective of providers. Methods: A qualitative study was applied using documents review and face-to-face semi-structured interviews with the program leads and relevant executive managers of the local medical universities. Thematic analysis was used to analyze the data. Results: Three main themes and nine subthemes were explored, including program planning (the content and the strengths, weaknesses, and corrective measures, implementation (executive mechanisms at the university level, establishment of referral system, collaboration between deputies of health and treatment, information dissemination mechanisms, satisfaction measurement and strengths, weaknesses and corrective measures, and result (implementation results. Conclusions: The urban phase of the specialized care program for diabetic′s patients has been a good base to improve continuity of care, which emphasizes on controlling and prevention of occurrence or progression of chronic complications of diabetes. This model can also be used for better management of other chronic disease. However, there are still issues that should be considered and improved such as allocation of guaranteed resources, more trained health professionals, and more evidence based guidelines and protocols, better collaboration among medical universities′ deputies, clearer payment system for program evaluation and better information management system.
Kaltoft, Mette Kjer
All healthcare visions, including that of The TIGER (Technology-Informatics-Guiding-Educational-Reform) Initiative envisage a crucial role for nursing. However, its 7 descriptive pillars do not address the disconnect between Nursing Informatics and Nursing Ethics and their distinct communities in the clinical-disciplinary landscape. Each sees itself as providing decision support by way of information inputs and ethical insights, respectively. Both have reasons - ideological, professional, institutional - for their task construction, but this simultaneously disables each from engaging fully in the point-of-(care)-decision. Increased pressure for translating 'evidence-based' research findings into 'ethically-sound', 'value-based' and 'patient-centered' practice requires rethinking the model implicit in conventional knowledge translation and informatics practice in all disciplines, including nursing. The aim is to aid 'how nurses and other health care scientists more clearly identify clinical and other relevant data that can be captured to inform future comparative effectiveness research. 'A prescriptive, theory-based discipline of '(Nursing) Decisionics' expands the Grid for Volunteer Development of TIGER's newly launched virtual learning environment (VLE). This provides an enhanced TIGER-vision for educational reform to deliver ethically coherent, person-centered care transparently.
Reiber, Gayle E; Raugi, Gregory J; Rowberg, Donald
Delivering and documenting evidence-based treatment to all Department of Veterans Affairs (VA) foot ulcer patients has wide appeal. However, primary and secondary care medical centers where 52% of these patients receive care are at a disadvantage given the frequent absence of trained specialists to manage diabetic foot ulcers. A retrospective review of diabetic foot ulcer patient records and a provider survey were conducted to document the foot ulcer problem and to assess practitioner needs. Results showed of the 125 persons with foot ulcers identified through administrative data, only, 21% of diabetic foot patients were correctly coded. Chronic Care and Microsystem models were used to prepare a tailored intervention in a VA primary care medical center. The site Principal Investigators, a multidisciplinary site wound care team, and study investigators jointly implemented a diabetic foot ulcer program. Intervention components include wound care team education and training, standardized good wound care practices based on strong scientific evidence, and a wound care template embedded in the electronic medical record to facilitate data collection, clinical decision making, patient ordering, and coding. A strategy for delivering offloading pressure devices, regular case management support, and 24/7 emergency assistance also was developed. It took 9 months to implement the model. Patients were enrolled and followed for 1 year. Process and outcome evaluations are on-going.
Anogeianaki, Antonia; Ilonidis, George; Anogianakis, George; Lianguris, John; Katsaros, Kyriakos; Pseftogianni, Dimitra; Klisarova, Anelia; Negrev, Negrin
DIMNET is a training mechanism for a region of central Europe. The aim is to upgrade the information technology skills of local hospital personnel and preserve their employability following the introduction of medical informatics. DIMNET uses Internet-based virtual classrooms to provide a 200-hour training course in medical informatics. Training takes place in the cities of Drama, Kavala, Xanthi and Varna. So far, more than 600 people have benefited from the programme. Initial results are encouraging. DIMNET promotes a new vocational training culture in the Balkans and is supported by local governments that perceive health-care as a fulcrum for economic development.
Valenta, Annette L; Meagher, Emma A; Tachinardi, Umberto; Starren, Justin
Since the inception of the Clinical and Translational Science Award (CTSA) program in 2006, leaders in education across CTSA sites have been developing and updating core competencies for Clinical and Translational Science (CTS) trainees. By 2009, 14 competency domains, including biomedical informatics, had been identified and published. Since that time, the evolution of the CTSA program, changes in the practice of CTS, the rapid adoption of electronic health records (EHRs), the growth of biomedical informatics, the explosion of big data, and the realization that some of the competencies had proven to be difficult to apply in practice have made it clear that the competencies should be updated. This paper describes the process undertaken and puts forth a new set of competencies that has been recently endorsed by the Clinical Research Informatics Workgroup of AMIA. In addition to providing context and background for the current version of the competencies, we hope this will serve as a model for revision of competencies over time.
Fairbrother, Gerry; Trudnak, Tara; Christopher, Ronda; Mansour, Mona; Mandel, Keith
The Cincinnati, Ohio, metropolitan area was one of seventeen US communities to participate in the federal Beacon Community Cooperative Agreement Program to demonstrate how health information technology (IT) could be used to improve health care. Given $13.7 million to spend in thirty-one months, the Cincinnati project involved hundreds of physicians, eighty-seven primary care practices, eighteen major hospital partners, and seven federally qualified health centers and community health centers. The thrust of the program was to build a shared health IT infrastructure to support quality improvement through data exchange, registries, and alerts that notified primary care practices when a patient visited an emergency department or was admitted to a hospital. A special focus of this program was on applying these tools to adult patients with diabetes and pediatric patients with asthma. Despite some setbacks and delays, the basic technology infrastructure was built, the alert system was implemented, nineteen practices focusing on diabetes improvement were recognized as patient-centered medical homes, and many participants agreed that the program had helped transform care. However, the experience also demonstrated that the ability to transfer data was limited in electronic health record systems; that considerable effort was required to adapt technology to support quality improvement; and that the ambitious agenda required more time for planning, training, and implementation than originally thought.
Monse, B.; Naliponguit, E.; Belizario, V.; Benzian, H.; Palenstein Helderman, W.H. van
High prevalence of poverty diseases such as diarrhoea, respiratory tract infection, parasitic infections and dental caries among children in the developing world calls for a return to primary health care principles with a focus on prevention. The 'Fit for School' program in the Philippines is based
Kapp, Marshall B.
Argues there is a growing need for a core of professionals with the education and sensitivities necessary to integrate the fields of law, health care, and gerontology. Paper describes a professional development fellowship program which attempts to address this need by having recently graduated attorneys assess, on a firsthand level, provisions of…
... systems will test new reimbursement methods intended to ] create incentives for health care providers to... (CMMI) within CMS, which is authorized to test innovative payment and service delivery models to reduce... innovative payment and delivery system models that complement the Shared Savings Program in the CMMI. In...
An in-house staff development program was designed and implemented for unskilled child caregivers employed at Tiny Tots Educare Academies, Inc., a privately owned and operated child care center located in Ellenton, Florida. Employees had little knowledge of child development and other topics related to early childhood education and, therefore,…
VANDENBRINK, W; LEENSTRA, A; ORMEL, J; VANDEWILLIGE, G
This study examines the scientific basis for mental health intervention programs in primary care. The validity of five underlying assumptions is evaluated, using the results of a naturalistic study covering a representative sample of 25 Dutch family practices and data from the literature. Our findin
Thinhuatoey, Benjamard; Songwathana, Praneed; Petpichetchian, Wongchan
Because of the multifaceted process of weaning patients with prolonged mechanical ventilation, enhancing weaning success remains a challenge. The Care-Integrated Concentration Meditation Program was developed on the basis of Buddhist philosophy and implemented to determine its procedural feasibility. A qualitative case study with 3 participants was conducted, and the process and initial outcomes were evaluated.
Hooven, Carole; Herting, Jerald R.; Snedker, Karen A.
Objectives: To provide a long-term look at suicide risk from adolescence to young adulthood for former participants in Promoting CARE, an indicated suicide prevention program. Methods: Five hundred ninety-three suicide-vulnerable high school youth were involved in a long-term follow-up study. Latent class growth models identify patterns of change…
葛耀武; 王永波; 张明玉
Compared with developed countries, China's medical informatics education started late, the relevant departments of investment and attention is not enough, which caused our medical informatics education model and the level is relatively backward, thereby hampering our medical health level of development. This article based on the development of medical informatics status quo, to make a few constructive suggestions, we want to promote our country's medical informatics education, cultivate more excellent medical informatics professionals to meet the needs of health care jobs.%与发达国家相比较，我国的医学信息学教育起步时间较晚，相关部门的投入和重视程度也不够，由此造成了我国的医学信息学教育模式和水平相对落后，进而影响和制约了我国医疗卫生事业水平的发展。本文依据我国医学信息学发展的现状，提出几点建设性意见，希望对推动我国的医学信息学教育有所帮助，从而培养出更多的优秀医学信息学人才来满足医疗卫生岗位的需求。
Ruikes Franca GH
Full Text Available Abstract Background With increasing age and longevity, the rising number of frail elders with complex and numerous health-related needs demands a coordinated health care delivery system integrating cure, care and welfare. Studies on the effectiveness of such comprehensive chronic care models targeting frail elders show inconclusive results. The CareWell-primary care program is a complex intervention targeting community-dwelling frail elderly people, that aims to prevent functional decline, improve quality of life, and reduce or postpone hospital and nursing home admissions of community dwelling frail elderly. Methods/design The CareWell-primary care study includes a (cost- effectiveness study and a comprehensive process evaluation. In a one-year pragmatic, cluster controlled trial, six general practices are non-randomly recruited to adopt the CareWell-primary care program and six control practices will deliver ‘care as usual’. Each practice includes a random sample of fifty frail elders aged 70 years or above in the cost-effectiveness study. A sample of patients and informal caregivers and all health care professionals participating in the CareWell-primary care program are included in the process evaluation. In the cost-effectiveness study, the primary outcome is the level of functional abilities as measured with the Katz-15 index. Hierarchical mixed-effects regression models / multilevel modeling approach will be used, since the study participants are nested within the general practices. Furthermore, incremental cost-effectiveness ratios will be calculated as costs per QALY gained and as costs weighed against functional abilities. In the process evaluation, mixed methods will be used to provide insight in the implementation degree of the program, patients’ and professionals’ approval of the program, and the barriers and facilitators to implementation. Discussion The CareWell-primary care study will provide new insights into the (cost
Hopkins, Ramona O; Mitchell, Lorie; Thomsen, George E; Schafer, Michele; Link, Maggie; Brown, Samuel M
Immobility in the intensive care unit (ICU) is associated with neuromuscular weakness, post-intensive care syndrome, functional limitations, and high costs. Early mobility-based rehabilitation in the ICU is feasible and safe. Mobility-based rehabilitation varied widely across 5 ICUs in 1 health care system, suggesting a need for continuous training and evaluation to maintain a strong mobility-based rehabilitation program. Early mobility-based rehabilitation shortens ICU and hospital stays, reduces delirium, and increases muscle strength and the ability to ambulate. Long-term effects include increased ability for self-care, faster return to independent functioning, improved physical function, and reduced hospital readmission and death. Factors that influence early mobility-based rehabilitation include having an interdisciplinary team; strong unit leadership; access to physical, occupational, and respiratory therapists; a culture focused on patient safety and quality improvement; a champion of early mobility; and a focus on measuring performance and outcomes.
Allen, Suzanne M; Ballweg, Ruth A; Cosgrove, Ellen M; Engle, Kellie A; Robinson, Lawrence R; Rosenblatt, Roger A; Skillman, Susan M; Wenrich, Marjorie D
The authors examine the potential impact of the Patient Protection and Affordable Care Act (ACA) on a large medical education program in the Northwest United States that builds the primary care workforce for its largely rural region. The 42-year-old Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) program, hosted by the University of Washington School of Medicine, is one of the nation's most successful models for rural health training. The program has expanded training and retention of primary care health professionals for the region through medical school education, graduate medical education, a physician assistant training program, and support for practicing health professionals.The ACA and resulting accountable care organizations (ACOs) present potential challenges for rural settings and health training programs like WWAMI that focus on building the health workforce for rural and underserved populations. As more Americans acquire health coverage, more health professionals will be needed, especially in primary care. Rural locations may face increased competition for these professionals. Medical schools are expanding their positions to meet the need, but limits on graduate medical education expansion may result in a bottleneck, with insufficient residency positions for graduating students. The development of ACOs may further challenge building a rural workforce by limiting training opportunities for health professionals because of competing demands and concerns about cost, efficiency, and safety associated with training. Medical education programs like WWAMI will need to increase efforts to train primary care physicians and increase their advocacy for student programs and additional graduate medical education for rural constituents.
Melnick, Glenn A; Green, Lois; Rich, Jeremy
In 2009 HealthCare Partners Affiliates Medical Group, based in Southern California, launched House Calls, an in-home program that provides, coordinates, and manages care primarily for recently discharged high-risk, frail, and psychosocially compromised patients. Its purpose is to reduce preventable emergency department visits and hospital readmissions. We present data over time from this well-established program to provide an example for other new programs that are being established across the United States to serve this population with complex needs. The findings show that the initial House Calls structure, staffing patterns, and processes differed across the geographic areas that it served, and that they also evolved over time in different ways. In the same time period, all areas experienced a reduction in operating costs per patient and showed substantial reductions in monthly per patient health care spending and hospital utilization after enrollment in the House Calls program, compared to the period before enrollment. Despite more than five years of experience, the program structure continues to evolve and adjust staffing and other features to accommodate the dynamic nature of this complex patient population.
St Andre, Arthur
Leaders of critical care programs have significant responsibility to develop and maintain a system of intensive care. At inception, those clinician resources necessary to provide and be available for the expected range of patient illness and injury and throughput are determined. Simultaneously, non-ICU clinical responsibilities and other expectations, such as education of trainees and participation in hospital operations, must be understood. To meet these responsibilities, physicians must be recruited, mentored, and retained. The physician leader may have similar responsibilities for nonphysician practitioners. In concert with other critical care leaders, the service adopts a model of care and assembles an ICU team of physicians, nurses, nonphysician providers, respiratory therapists, and others to provide clinical services. Besides clinician resources, leaders must assure that services such as radiology, pharmacy, the laboratory, and information services are positioned to support the complexities of ICU care. Metrics are developed to report success in meeting process and outcomes goals. Leaders evolve the system of care by reassessing and modifying practice patterns to continually improve safety, efficacy, and efficiency. Major emphasis is placed on the importance of continuity, consistency, and communication by expecting practitioners to adopt similar practices and patterns. Services anticipate and adapt to evolving expectations and resource availability. Effective services will result when skilled practitioners support one another and ascribe to a service philosophy of care.
Full Text Available This paper argues that the health unit program developed in Sri Lanka in the early twentieth century was an earlier model of selective primary health care promoted by the Rockefeller Foundation in the 1980s in opposition to comprehensive primary health care advocated by the Alma-Ata Declaration of the World Health Organization. A key strategy of the health unit program was to identify the most common and serious infectious diseases in each health unit area and control them through improved sanitation, health education, immunization and treatment with the help of local communities. The health unit program was later introduced to other countries in South and Southeast Asia as part of the Rockefeller Foundation's global campaign to promote public health.
Full Text Available Gill Lewin,1 Karyn Concanen,2 David Youens3 1School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia; 2Silver Chain Group, Osborne Park, WA, Australia; 3Faculty of Health Science, Curtin University, Perth, WA, Australia Abstract: The Home Independence Program (HIP, an Australian restorative home care/reablement service for older adults, has been shown to be effective in reducing functional dependency and increasing functional mobility, confidence in everyday activities, and quality of life. These gains were found to translate into a reduced need for ongoing care services and reduced health and aged care costs over time. Despite these positive outcomes, few Australian home care agencies have adopted the service model – a key reason being that few Australian providers employ health professionals, who act as care managers under the HIP service model. A call for proposals from Health Workforce Australia for projects to expand the scope of practice of health/aged care staff then provided the opportunity to develop, implement, and evaluate a service delivery model, in which nonprofessionals replaced the health professionals as Care Managers in the HIP service. Seventy older people who received the HIP Coordinator (HIPC service participated in the outcomes evaluation. On a range of personal outcome measures, the group showed statistically significant improvement at 3 and 12 months compared to baseline. On each outcome, the improvement observed was larger than that observed in a previous trial in which the service was delivered by health professionals. However, differences in the timing of data collection between the two studies mean that a direct comparison cannot be made. Clients in both studies showed a similarly reduced need for ongoing home care services at both follow-up points. The outcomes achieved by HIPC, with non-health professionals as Care Managers, were positive and can be considered to compare favorably
Holden, Martha J.; Izzo, Charles; Nunno, Michael; Smith, Elliott G.; Endres, Thomas; Holden, Jack C.; Kuhn, Frank
This paper describes an effort to bridge research and practice in residential care through implementing a program model titled Children and Residential Experiences (CARE). The strategy involves consulting at all levels of the organization to guide personnel to incorporate CARE evidence-based principles into daily practice, and fostering an…
This book provides a broad overview of the topic Bioinformatics (medical informatics + biological information) with a focus on data, information and knowledge. From data acquisition and storage to visualization, privacy, regulatory, and other practical and theoretical topics, the author touches on several fundamental aspects of the innovative interface between the medical and computational domains that form biomedical informatics. Each chapter starts by providing a useful inventory of definitions and commonly used acronyms for each topic, and throughout the text, the reader finds several real-world examples, methodologies, and ideas that complement the technical and theoretical background. Also at the beginning of each chapter a new section called "key problems", has been added, where the author discusses possible traps and unsolvable or major problems. This new edition includes new sections at the end of each chapter, called "future outlook and research avenues," providing pointers to future challenges.
Cybernetics and informatics being a high-profile and fast-moving fields, the papers included in this proceedings will command a wide professional and academic readership. This book covers the very latest developments in the field of cybernetics and informatics. The 2012 conference in Chongqing, China, combined a focus on innovative technologies with an emphasis on sustainable solutions and strategies. Attended by leading figures from academia and industry whose work is represented here, the conference allowed effective cross-pollination between the theoretical and applied sectors of the field. Conference organizers received more than 1,000 papers, of which only ten percent were chosen to be featured in this publication. All of the papers are at the leading edge of developments, and so this book will not only ensure that the very best current work is disseminated, but that it also acts as a spur to future research.
Full Text Available In this paper different aspects regarding smart metering systems integration have been depicted. Smart metering systems, renewable energy sources integration and advanced tariff systems implementation require informatics solution that could automatically collect and process data, forecast the behavior of electricity consumers, analyze trends regarding electricity prices, optimize the consumption of consumers, provide friendly interfaces, etc. They are advanced technologies that represent solutions for insufficient conventional primary energy sources, gas emissions, dependency on energy sources located outside European Union and issues related to energy efficiency. This paper mainly describes several informatics solutions correlated with operational requirements for smart metering system and our proposal for simplified architecture of smart metering systems, with three distinct levels (base level, middle level and top level and load profile calculation methods.
Swedlow, Jason R; Eliceiri, Kevin W
Significant technical advances in imaging, molecular biology and genomics have fueled a revolution in cell biology, in that the molecular and structural processes of the cell are now visualized and measured routinely. Driving much of this recent development has been the advent of computational tools for the acquisition, visualization, analysis and dissemination of these datasets. These tools collectively make up a new subfield of computational biology called bioimage informatics, which is facilitated by open source approaches. We discuss why open source tools for image informatics in cell biology are needed, some of the key general attributes of what make an open source imaging application successful, and point to opportunities for further operability that should greatly accelerate future cell biology discovery.
... provide a forum for community-based organizations, hospitals, Quality Improvement Organizations... materials will be posted on the CMS Care Transitions Web site prior to the meeting. FOR FURTHER INFORMATION CONTACT: Juliana Tiongson, Social Science Research Analyst, Centers for Medicare & Medicaid Services,...
Since June 1973, Iowa Lakes Community College (Iowa) has been conducting an in-service training program for employees of local nursing homes. The program was designed to upgrade the participants' knowledge of the mental health aspects of care for the aged and to improve their abilities to provide physical health care. The specific objectives of…
... MANAGEMENT 45 CFR Part 800 RIN 3206-AM47 Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the Affordable Insurance Exchanges; Correction AGENCY: U.S. Office of... Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...
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... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program....'' SUPPLEMENTARY INFORMATION: Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10.... Abstract: VA Form 10-0476 will be used to gather feedback from patients regarding their satisfaction...
... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program... needed to determine patients' satisfaction with services provided by or through the Michael E. DeBakey.... Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10-0476. OMB...
... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program.... This notice solicits comments on information needed to determine patients' satisfaction with services... information technology. Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form...
Ryan, Catherine J; Choi, Heeseung; Fritschi, Cynthia; Hershberger, Patricia E; Vincent, Catherine V; Hacker, Eileen Danaher; Zerwic, Julie J; Norr, Kathleen; Park, Hanjong; Tastan, Sevinc; Keenan, Gail M; Finnegan, Lorna; Zhao, Zhongsheng; Gallo, Agatha M; Wilkie, Diana J
Computer technology provides innovations for research but not without concomitant challenges. Herein, we present our experiences with technology challenges and solutions across 16 nursing research studies. Issues included intervention integrity, software updates and compatibility, web accessibility and implementation, hardware and equipment, computer literacy of participants, and programming. Our researchers found solutions related to best practices for computer-screen design and usability testing, especially as they relate to the target populations' computer literacy levels and use patterns; changes in software; availability and limitations of operating systems and web browsers; resources for on-site technology help for participants; and creative facilitators to access participants and implement study procedures. Researchers may find this information helpful as they consider successful ways to integrate informatics in the design and implementation of future studies with technology that maximizes research productivity.
Mitchell, John B O
This article reviews the use of informatics and computational chemistry methods in medicinal chemistry, with special consideration of how computational techniques can be adapted and extended to obtain more and higher-quality information. Special consideration is given to the computation of protein-ligand binding affinities, to the prediction of off-target bioactivities, bioactivity spectra and computational toxicology, and also to calculating absorption-, distribution-, metabolism- and excretion-relevant properties, such as solubility.
Jarrott, Shannon E; Gigliotti, Christina M
Engaging persons with dementia in meaningful activities supports well-being; however, care staff are challenged to implement age- and ability-appropriate activities in a group setting. We compared a randomly assigned treatment group, who received horticultural therapy-based (HT-based) programming to a comparison group, who engaged in traditional activities (TA) programming, on engagement and affect. Horticultural therapy-based programming was implemented twice weekly at 4 treatment sites for 6 weeks, while regular TA were observed at comparison sites. Results revealed no differences between groups on affective domains. Levels of adaptive behavior differed between the groups, with the treatment group demonstrating higher levels of active, passive, and other engagement and the comparison group demonstrating higher levels of self-engagement. Our results highlight the value of HT-based programs and the importance of simultaneously capturing participants' affective and behavioral responses. Theoretical and practical considerations about the facilitation of and context in which the programming occurs are discussed.
Braunstein, Mark L
Despite its high cost, the US healthcare system produces relatively short life spans, and is wasteful, inefficient and has serious safety and quality issues. While other industries have surmounted similar challenges by transforming themselves through information technology, healthcare lags behind. Major reasons are that our approaches to care delivery and financial incentives were designed for a bygone era. Beyond that the technology offered to practitioners has often been overly expensive, poorly designed, overly proprietary, hard to implement and difficult to use. Spurred by a unique, on
Chile is in the throes of health reforms aimed at ensuring that every person with specified chronic diseases receives timely and high quality care. CITs are crucial to the achievement of this vision because they make it possible to manage information and knowledge in a more efficient way. Until a few years ago, the incorporation of CITs was limited to individual initiatives, but since 2004 there has been a master plan to coordinate this task in the public sector. Some projects are now operative but there is still a long road to travel before getting to our destination. One of the most underdeveloped areas is the clinical applications of health CITs, especially the incorporation of biomedical knowledge to clinical practice. The two biggest challenges facing the Digital Agenda for the health care system are (i) to develop a critical mass of clinicians and health related professionals with expertise in Health Informatics; and (ii) to foster technical integration of the private and public sectors of the health care market.
Dragos Palaghita; Bogdan Vintila
The paper highlights the analysis of informatics security costs for the citizen oriented applications. The citizen oriented informatics applications are defined. The differences brought by these when compared with the traditional applications are described. Structures of citizen oriented informatics applications are presented. A few common citizen oriented applications are discussed. The special security requirements of the citizen oriented applications are discussed. Ways of increasing the s...
Full Text Available Mongolia started using Information and Communication Technology (ICT in secondary education relatively late. The computer training and informatics has been included as a subject in the secondary school curriculum in Mongolia since 1988 and in the university curriculum since 1982. This paper presents current situation of informatics education in Mongolia. SWOT (Strength, Weakness, Opportunity, and Threat analysis of Informatics Education in Mongolia, conclusions and future recommendations are also presented.
Hambly, Kevin; Danzer, Joseph; Muskal, Steven; Debe, Derek A
Structural genomics projects are producing protein structure data at an unprecedented rate. In this paper, we present the Target Informatics Platform (TIP), a novel structural informatics approach for amplifying the rapidly expanding body of experimental protein structure information to enhance the discovery and optimization of small molecule protein modulators on a genomic scale. In TIP, existing experimental structure information is augmented using a homology modeling approach, and binding sites across multiple target families are compared using a clique detection algorithm. We report here a detailed analysis of the structural coverage for the set of druggable human targets, highlighting drug target families where the level of structural knowledge is currently quite high, as well as those areas where structural knowledge is sparse. Furthermore, we demonstrate the utility of TIP's intra- and inter-family binding site similarity analysis using a series of retrospective case studies. Our analysis underscores the utility of a structural informatics infrastructure for extracting drug discovery-relevant information from structural data, aiding researchers in the identification of lead discovery and optimization opportunities as well as potential "off-target" liabilities.
Grain, Heather; Hovenga, Evelyn
There is a widespread consensus that we have an urgent need to improve our workforce capacity in all aspects associated with the skills and knowledge required for successful e-health and health informatics developments, associated change management and systems implementation strategies. Such activities aim to support various health reform policy initiatives. This paper considers the work being undertaken by many researchers around the globe to define the range of skills and knowledge requirements to suit this purpose. A number of requirements and areas of specialisation are detailed. This is followed by descriptions for competencies in general and more specifically descriptions of a set of high level agreed Health Informatics competencies. Collectively these competencies provide a suitable framework useful for the formal recognition of Health Informatics, including e-health, as a nationally recognised study discipline. Nationally agreed competencies for this discipline enables all education and training efforts to be consistently implemented and to fit with the Australian Qualifications Framework covering both the Vocational Education and Training (VET) and Higher Education sectors.
Hübner, Ursula; Shaw, Toria; Thye, Johannes; Egbert, Nicole; Marin, Heimar; Ball, Marion
Informatics competencies of the health care workforce must meet the requirements of inter-professional process and outcome oriented provision of care. In order to help nursing education transform accordingly, the TIGER Initiative deployed an international survey, with participation from 21 countries, to evaluate and prioritise a broad list of core competencies for nurses in five domains: 1) nursing management, 2) information technology (IT) management in nursing, 3) interprofessional coordination of care, 4) quality management, and 5) clinical nursing. Informatics core competencies were found highly important for all domains. In addition, this project compiled eight national cases studies from Austria, Finland, Germany, Ireland, New Zealand, the Philippines, Portugal, and Switzerland that reflected the country specific perspective. These findings will lead us to an international framework of informatics recommendations.
Kelly, Ronald; Godin, Lori
This study is an evaluation of a unique "surveillance nurse" telephone support intervention for community-dwelling elderly individuals in a home care program. A combined propensity-based covariate-matching procedure was used to pair each individual who received the intervention ("treatment" condition, nT = 930) to a similar individual who did not receive the intervention ("control" condition, nC1 = 930) from among a large pool of potential control individuals (nC0 = 4656). The intervention consisted of regularly scheduled telephone calls from a surveillance nurse to proactively assess the individual's well-being, care plan status, use of and need for services (home support, adult day program, physiotherapy, etc.) and home environment (e.g., informal caregiver support). Treatment and control conditions were compared with respect to four service utilization outcomes: (1) rate of survival in the community before institutionalization in an assisted living or nursing home facility or death, (2) rate of emergency room registrations, (3) rate of acute care hospitalizations, and (4) rate of days in hospital, during home care enrollment. Results indicated a beneficial effect of the surveillance nurse intervention on reducing rate of service utilization by increasing the duration of the home care episode.
Nemeth, Noel N.
Brittle materials are being used, or considered, for a wide variety of high tech applications that operate in harsh environments, including static and rotating turbine parts. thermal protection systems, dental prosthetics, fuel cells, oxygen transport membranes, radomes, and MEMS. Designing components to sustain repeated load without fracturing while using the minimum amount of material requires the use of a probabilistic design methodology. The CARES/Life code provides a general-purpose analysis tool that predicts the probability of failure of a ceramic component as a function of its time in service. For this presentation an interview of the CARES/Life program will be provided. Emphasis will be placed on describing the latest enhancements to the code for reliability analysis with time varying loads and temperatures (fully transient reliability analysis). Also, early efforts in investigating the validity of using Weibull statistics, the basis of the CARES/Life program, to characterize the strength of MEMS structures will be described as as well as the version of CARES/Life for MEMS (CARES/MEMS) being prepared which incorporates single crystal and edge flaw reliability analysis capability. It is hoped this talk will open a dialog for potential collaboration in the area of MEMS testing and life prediction.
Full Text Available Recent research indicates a definite positive impact on treatment outcomes when an integrative approach that focuses on symptom control and quality of life is provided along with the standard therapeutic regimens. However implementation or practice of this approach is not seen widely due to the culture of medical training and practice. This article presents the initial development of a program for incorporating integrative care principles into an ongoing comprehensive cancer care program at a tertiary centre. The key purpose of the program being to develop, facilitate, and establish comprehensive and holistic processes including palliative care principles, that would positively enhance the quantity and quality of life of the person with disease, as well as create an environment that reflects and sustains this approach. The vision, objectives, goals, strategies, activities and results within the 7 months of implementation are documented. The new learnings gained during the process have also been noted in the hope that the model described may be used to conceptualize similar care giving facilities in other centres.
Chao, Chia-Ter; Tsai, Hung-Bin; Shih, Chih-Yuan; Hsu, Su-Hsuan; Hung, Yu-Chien; Lai, Chun-Fu; Ueng, Ruey-Hsiuang; Chan, Ding-Cheng; Hwang, Juey-Jen; Huang, Sheng-Jean
Renal supportive care (RSC) denotes a care program dedicated for patients with acute, chronic renal failure, and end-stage renal disease (ESRD), aiming to offer maximal symptom relief and optimize patients' quality of life. The uncertainty of prognosis for patients with chronic kidney disease and ESRD, the sociocultural issues inherent to the Taiwanese society, and the void of structured and practical RSC pathway, contributes to the underrecognition and poor utilization of RSC. Taiwanese patients rarely receive information regarding RSC as part of a standardized care and are not commonly offered this option. In National Taiwan University Hospital Jinshan branch, we started a RSC subprogram, supported by the community-based palliative/hospice care main program. We focused on understanding the need and providing the choice of RSC to suitable candidates. A three-step and four-phase protocol was designed and implemented to identify appropriate patients and to enhance the applicability of the RSC. We harnessed family visit and home-based family meeting as a vehicle to understand the patients' preferences, to discover what ESRD patients and their family value most, and to introduce the option of RSC. In the current review, we described our pilot experience of establishing a RSC program in Taiwan, and discuss its potential advantage.
Ellis, Beverley; Roberts, Jean; Cooper, Helen
This case study report of the establishment of a national repository of multi-media materials describes the creation process, the challenges faced in putting it into operation and the opportunities for the future. The initial resource has been incorporated under standard library and knowledge management practices. A collaborative action research method was used with active experts in the domain to determine the requirements and priorities for further development. The National Health Informatics Collection (NatHIC) is now accessible and the further issues are being addressed by inclusion in future University and NHS strategic plans. Ultimately the Collection will link with other facilities that contribute to the description and maintenance of effective informatics in support of health globally. The issues raised about the National Health Informatics Collection as established in the UK have resonance with the challenges of capturing the overall historic development of an emerging discipline in any country.
Full Text Available Gill F Lewin,1,2 Helman S Alfonso,3 Janine J Alan41Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 2Research Department, Silver Chain Group, Perth, WA, Australia; 3School of Population Health, University of Western Australia, Perth, WA, Australia; 4Faculty of Health Sciences, Curtin University, Perth, WA, AustraliaBackground: The objectives of this study were to determine whether older individuals who participated in a reablement (restorative program rather than immediately receiving conventional home care services had a reduced need for ongoing support and lower home care costs over the next 57 months (nearly 5 years.Materials and methods: Data linkage was used to examine retrospectively the service records of older individuals who had received a reablement service versus a conventional home care service to ascertain their use of home care services over time.Results: Individuals who had received a reablement service were less likely to use a personal care service throughout the follow-up period or any other type of home care over the next 3 years. This reduced use of home care services was associated with median cost savings per person of approximately AU $12,500 over nearly 5 years.Conclusion: The inclusion of reablement as the starting point for individuals referred for home care within Australia's reformed aged care system could increase the system's cost effectiveness and ensure that all older Australians have the opportunity to maximize their independence as they age.Keywords: restorative, older adults, community dwelling, service costs
Faucher, Joshua; Rosedahl, Jordan; Finnie, Dawn; Glasgow, Amy; Takahashi, Paul
Background Transitional care programs are common interventions aimed at reducing medical complications and associated readmissions for patients recently discharged from the hospital. While organizations strive to reduce readmissions, another important related metric is patient quality of life (QoL). Aims To compare the relationship between QoL in patients enrolled in the Mayo Clinic Care Transitions (MCCT) program versus usual care, and to determine if QoL changed in MCCT participants between baseline and 1-year follow-up. Methods A baseline survey was mailed to MCCT enrollees in March 2013. Those who completed a baseline survey were sent a follow-up survey 1 year later. A cross-sectional survey of usual care participants was mailed in November 2013. We included in our analysis 199 participants (83 in the MCCT and 116 in usual care) aged over 60 years with multiple comorbidities and receiving primary care. Primary outcomes were self-rated QoL; secondary outcomes included self-reported general, physical, and mental health. Intra- and intergroup comparisons of patients were evaluated using Pearson’s chi-squared analysis. Results MCCT participants had more comorbidities and higher elder risk assessment scores than those receiving usual care. At baseline, 74% of MCCT participants reported responses of good-to-excellent QoL compared to 64% after 1 year (P=0.16). Between MCCT and usual care, there was no significant difference in self-reported QoL (P=0.21). Between baseline and follow-up in MCCT patients, and compared to usual care, there were no significant differences in self-reported general, physical, or mental health. Conclusion We detected no difference over time in QoL between MCCT patients and those receiving usual care, and a nonsignificant QoL decline in MCCT participants after 1 year. Progression of chronic disease may overwhelm any QoL improvement attributable to the MCCT intervention. The MCCT interventions may blunt expected declines in QoL, producing
Yoon, Sunmoo; Shaffer, Jonathan A; Bakken, Suzanne
Healthcare environments are increasingly implementing health information technology (HIT) and those from various professions must be competent to use HIT in meaningful ways. In addition, HIT has been shown to enable interprofessional approaches to health care. The purpose of this article is to describe the refinement of the Self-Assessment of Nursing Informatics Competencies Scale (SANICS) using analytic techniques based upon item response theory (IRT) and discuss its relevance to interprofessional education and practice. In a sample of 604 nursing students, the 93-item version of SANICS was examined using non-parametric IRT. The iterative modeling procedure included 31 steps comprising: (1) assessing scalability, (2) assessing monotonicity, (3) assessing invariant item ordering, and (4) expert input. SANICS was reduced to an 18-item hierarchical scale with excellent reliability. Fundamental skills for team functioning and shared decision making among team members (e.g. "using monitoring systems appropriately," "describing general systems to support clinical care") had the highest level of difficulty, and "demonstrating basic technology skills" had the lowest difficulty level. Most items reflect informatics competencies relevant to all health professionals. Further, the approaches can be applied to construct a new hierarchical scale or refine an existing scale related to informatics attitudes or competencies for various health professions.
Truccolo, Ivana; Cipolat Mis, Chiara; Cervo, Silvia; Dal Maso, Luigino; Bongiovanni, Marilena; Bearz, Alessandra; Sartor, Ivana; Baldo, Paolo; Ferrarin, Emanuela; Fratino, Lucia; Mascarin, Maurizio; Roncadin, Mario; Annunziata, Maria Antonietta; Muzzatti, Barbara; De Paoli, Paolo
In Italy, educational programs for cancer patients are currently provided by the national government, scientific societies, and patient advocate organizations. Several gaps limit their effectiveness, including the lack of coordinated efforts, poor involvement of patient feedback in the planning of programs, as well as a lack of resources on innovative cancer-related topics. This process is parallel to a strong shift in the attitude of patients towards health in general and taking charge of their own health conditions in particular. The National Cancer Institute in the USA and the Organization of European Cancer Institutes encourage comprehensive cancer centers in providing educational programs conceived to overcome these gaps. The goal of this paper is to identify and describe the key elements necessary to develop a global patient education program and provide recommendations for strategies with practical examples for implementation in the daily activities of cancer institutes. A multidisciplinary committee was established for patient education, including patient representatives as equal partners, to define, implement, verify, and evaluate the fundamental steps for establishing a comprehensive education program. Six essential topics were identified for the program: appropriate communication of cancer epidemiology, clinical trial information, new therapeutic technologies, support in the use of medicines, psycho-oncological interventions, age-personalized approaches, and training programs for healthcare providers. Integration of these topics along with patient feedback is the key to a successful model for educational programs. An integrated educational program can transform a comprehensive cancer center to an institution that provides research and care for and with patients.
Despite the fast pace of recent innovation within the health information technology and research informatics domains, there remains a large gap between research and academia, while interest in translating research innovations into implementations in the patient care settings is lacking. This is due to absence of common outcomes and performance measurement targets, with health information technology industry employing financial and operational measures and academia focusing on patient outcome concerns. The paper introduces methodology for and roadmap to introduction of common objectives as a way to encourage better collaboration between industry and academia using patient outcomes as a composite measure of demonstrated success from health information systems investments. Along the way, the concept of economics of health informatics, or "infonomics," is introduced to define a new way of mapping future technology investments in accordance with projected clinical impact.
Full Text Available Background and Objective: Hypertension is a preventable health risk. Thus, it is necessary to pay attention to hypertention in order to decrease macrovascular and microvascular complications of diabetes mellitus. This study examines the effect of the self-care program on the blood pressure of patients with diabetes. Materials and Method: This study was a randomized clinical trial performed on 134 patients with type 2 diabetes in the Diabetes Center in Sirajn, Iran, in 2011. The participants were assigned randomly into 2 groups of intervention and control (n = 67 using a random number table. The study tools consisted of a demographic information questionnaire and sphygmomanometer. The blood pressure of participants in both groups was measured before the intervention and every month during the intervention (for 3 months. The self-care program was conducted according to regulatory protocols in 6 sessions of 90 minutes for 6 weeks in the intervention group. Data were analyzed using SPSS software version 15, and descriptive statistics (mean, relative frequency and repeated measure ANOVA, chi-squared test. Results: No difference was observed between mean systolic blood pressure of the two study groups after the intervention at different times of measurement. However, mean diastolic blood pressure of the two groups showed a significant difference (P = 0.001. Conclusion: The results showed that implementation of the self-care program can reduce diastolic blood pressure in type 2 diabetic patients. Therefore, the use of this program is recommended in diabetic patients in order to control diabetes complications.
Oleg M. Spirin
Full Text Available In the article on the basis of analysis of such concepts as information, informative and informatics processes, system and technology, and competences, the definitions of "information and communication competence" and "informatics competence " are specified. It is determined the structure and place of such competences in the system of professional- specialized competence of informatics teacher. New determination of concept "information and communication technologies" is offered.
Full Text Available Abstract Background Patients often experience changes or transitions in where and by whom they are cared for at the end of life. These cause stress for both patients and families. Although not all transitions during the end of life can be avoided, advance identification of those who could potentially experience numerous transitions may allow providers and caregivers to anticipate the problem and consider strategies to minimize their occurrence. This study examines the relationship between patient characteristics and the total number of transitions experienced by the patient from the date of admission to a palliative care program (PCP to death and during final weeks of life. Methods Subjects included all adults registered with the PCP in Halifax, Nova Scotia, Canada between 1998 and 2002 and who had died during that period. Data was extracted from the regional PCP database and linked to census information. Transitions were defined as either: 1 a change in location of where the patient was cared for; or 2 a change in which service (specialist groupings, primary care, etc provided care. Descriptive statistics were calculated plus rate ratios for the association between patient characteristics and total number of transitions. Results In total, 3972 patients made 5903 transitions during the study period. Although 28% experienced no transitions, over 40% experienced one and 6.3% five or more. At least one transition was made by 47% during the last four weeks of life. Adjusted results suggest women, the elderly and more recent death are associated with experiencing fewer transitions. Multiple transitions were associated with a hospital death and a cancer diagnosis. During the last month of life, age was no longer associated with the total number of transitions, cancer patients were found to experience a similar number or fewer transitions than patients with a non-cancer diagnosis and pain and symptom control become a significant factor associated with
Paula Alvarenga de Figueiredo
Full Text Available Objectives: describe care needs and demands that mark the discursive practices of ostomized clients and family members and discuss guidelines for a comprehensive care program to ostomized clients and their families, organized by macrosociological categories. Method: Creative and Sensitive, involving 17 ostomized subjects and family members at a municipal outpatient clinic. The ethical aspects were complied with. A characterization form was used, as well as Creativity and Sensitivity Dynamics: "speaking map", "body-knowledge" and "calendar". Critical Discourse Analysis was applied. Results: the health needs and care demands of the ostomized patients and their family members, in their multiple dimensions, were constituted in the home and community, outpatient and social context, implying new orientations for nursing care. The unveiling of the data brought elements that constituted guidelines, in a macrosociological approach, to achieve the expanded integrality of nursing care. Conclusion: the ostomized clients are unique in their genre/peculiar from Latin sui generis, calling for strategies that respond to and distinguish their specificities. Elaborating a Public Health Policy that improves and reorganizes the care demands, taking into account these individual biopsychosocial and spiritual aspects, is a possible and irrevocable target in the attempt to achieve better conditions of health and wellbeing.
Academic Medicine, 1999
The report of the Association of American Medical Colleges' Medical School Objectives Program presents the work of two expert panels. One, on medical informatics, identified five important physician roles: lifelong learner, clinician, educator, researcher, and manager. Another panel established a definition for "population health perspective"…
Cassel, J Brian; Kerr, Kathleen M; Kalman, Noah S; Smith, Thomas J
Specialist palliative care (PC) often embraces a "less is more" philosophy that runs counter to the revenue-centric nature of most health care financing in the U.S. A special business case is needed in which the financial benefits for organizations such as hospitals and payers are aligned with the demonstrable clinical benefits for patients. Based on published studies and our work with PC programs over the past 15 years, we identified 10 principles that together form a business model for specialist PC. These principles are relatively well established for inpatient PC but are only now emerging for community-based PC. Three developments that are key for the latter are the increasing penalties from payers for overutilization of hospital stays, the variety of alternative payment models such as accountable care organizations, which foster a population health management perspective, and payer-provider partnerships that allow for greater access to and funding of community-based PC.
... Plans and Integration of Community Resources 11. ACO Marketing Guidelines 12. Program Integrity... Agency for Healthcare Research and Quality BCBSMA Blue Cross Blue Shield of Massachusetts BIPA Benefits... to determine an appropriate method to assign Medicare FFS beneficiaries to an ACO participating...
Passik, Steven D; Ruggles, Carol; Brown, Gretchen; Snapp, Janet; Swinford, Susan; Gutgsell, Terrence; Kirsh, Kenneth L
The value of integrating palliative with curative modes of care earlier in the course of disease for people with life threatening illnesses is well recognized. Whereas the now outdated model of waiting for people to be actively dying before initiating palliative care has been clearly discredited on clinical grounds, how a better integration of modes of care can be achieved, financed and sustained is an ongoing challenge for the health care system in general as well as for specific institutions. When the initiative comes from a hospital or academic medical center, which may, for example, begin a palliative care consultation service, financial benefits have been well documented. These palliative care services survive mainly by tracking cost savings that can be realized in a number of ways around a medical center. We tried to pilot 3 simple models of potential cost savings afforded to hospice by initiating a palliative care program. We found that simple models cannot capture this benefit (if it in fact exists). By adding palliative care, hospice, while no doubt improving and streamlining care, is also taking on more complex patients (higher drug costs, shorter length of stay, more outpatient, emergency room and physician visits). Indeed, the hospice was absorbing the losses associated with having the palliative care program. We suggest that an avenue for future exploration is whether partnering between hospitals and hospice programs can defray some of the costs incurred by the palliative care program (that might otherwise be passed on to hospice) in anticipation of cost savings. We end with a series of questions: Are there financial benefits? Can they be modeled and quantified? Is this a dilemma for hospice programs wanting to improve the quality of care but who are not able on their own to finance it?
Full Text Available Abstract Background Previous clinical trials have assessed the percentage of participants who utilized further health care after a period of conservative care for low back pain, however no chiropractic clinical trial has determined the total amount of care during this time and any differences based on assigned treatment group. The objective of this clinical trial follow-up was to assess if there was a difference in the total number of office visits for low back pain over one year after a four week clinical trial of either a form of physical therapy (Exercise Program or a form of chiropractic care (Flexion Distraction for chronic low back pain. Methods In this randomized clinical trial follow up study, 195 participants were followed for one year after a four-week period of either a form of chiropractic care (FD or a form of physical therapy (EP. Weekly structured telephone interview questions regarded visitation of various health care practitioners and the practice of self-care for low back pain. Results Participants in the physical therapy group demonstrated on average significantly more visits to any health care provider and to a general practitioner during the year after trial care (p Conclusion During a one-year follow-up, participants previously randomized to physical therapy attended significantly more health care visits than those participants who received chiropractic care.
Ali Akbar Vaezi
Full Text Available Background: Nurses are the main members in nursing cares and nursing managers can improve their clinical competency by applying better leadership skills. This study carried out to determine the effect of nursing management program on clinical competency of nurses in a coronary care unit (CCU.Methods: A quasi-experimental study was carried out in two educational hospitals in Yazd- Iran. These hospitals were allocated randomly in case and control hospitals. 25 matched nurses were selected by convenience sampling from both case and control hospitals. The clinical competency of nurses was measured by related questioners consisted of two dimensions caring and care management behaviors by self-evaluation and head nurse evaluation in case and control groups. Then, the intervention was implemented in four stages including nurse's development, managers' development, adaptation and supervision period during four months in the case group. After intervention, clinical competency of nurses was measured in both groups.Results: The results showed that before intervention more than 80% of nurses in two groups was in the moderate clinical competency level and they were proficient based on Benner's skill acquisition model. After intervention, nurses' clinical competency improved to higher level in case group but it didn't change in control group (P<0.05. Conclusion: Creating necessary modifications in nursing environments through the management development program by head nurses may improve nurses' clinical competency.
The purpose of this paper was to describe the development and testing of a computer simulation program designed to assess the decision-making process in the public health nurses' work in child health care. The work was based primarily on theories of problem-solving and decision making; on knowledge of child development, health care, and education; and on the soft systems methodology. An authoring program and two simulations were designed and produced at the University of Turku by a team of two nurse researchers, a computer specialist, and three public health nurses. The simulations presented two typical situations encountered by the public health nurses' work in child health care. A total of 61 public health nurses from 11 health centers in the southwestern part of Finland completed the simulations. The public health nurses responded positively to the simulations and the program worked very well. The results revealed some inconsistencies in the decision-making process of the public health nurses with respect to the needs of the child and the family. The public health nurses' decisions were more closely related to the developmental stage of the child than to the unique needs of each family. The simulation is acting to test the public health nurses' ability to make decisions "here and now" but not about caring it forward. These shortcomings can be corrected by asking them to explain their decisions and thoughts after each stage and by tape recording their answers. The findings gave many answers to the question of how the computer simulation program can be developed.
Kraus, Mark L.; Isaacson, J. Harry; Kahn, Ruth; Mundt, Marlon P.; Manwell, Linda Baier
In June 1998, there were 1.8 million inmates in correctional facilities for adults; 1.2 million in state and federal prisons and 600,000 in municipal/county jails (668 persons per 100,000 U.S. population). Rates of TB, AIDS, mental illness, and substance abuse are 2-13 times higher in persons living in jails and prisons. This study was designed to assess the level of training offered to residents in seven medical specialties in the care of addicted incarcerated persons. The study design involved two stages. The first entailed a mailed survey to 1,831 residency directors in family medicine, internal medicine, osteopathic medicine, pediatrics, obstetrics and gynecology, psychiatry, and emergency medicine. The second stage was a telephone interview, about substance use disorders, of faculty listed by the residency directors as teaching residents. The mailed survey was completed by 1,205 residency directors (66%). The 769 faculty from those identified programs, who participated in the telephone interview, reported that only 14% of their residency programs offered lectures or conferences on the care of incarcerated persons, yet 44% of the programs had residents caring for incarcerated persons with substance abuse problems, in a clinical setting. Only 22% offered clinical experiences for residents in a correctional facility.We recognize that our survey of correctional health and substance abuse training is limited, but as such, a greater number of respondents to our survey do not teach residents addiction medicine topics pertaining to prevention, evaluation, intervention, and management of the addicted criminal offender/patient in a correctional setting or give adequate clinical exposure to this special population. The data suggests a need to develop and implement educational programs on medical care for this high-risk and expanding population.
Full Text Available Each year, hundreds of thousands of children in the U.S. are victims of child maltreatment. Experts recommend behavioral, skill-based parent training programs as a strategy for the prevention of child abuse and neglect. These programs can be enhanced using innovative technology strategies. This paper presents a brief history of the use of technology in SafeCare®, a home visiting program shown to prevent child neglect and physical abuse, and highlights current work that takes a technology-based hybrid approach to SafeCare delivery. With this unique approach, the provider brings a tablet computer to each session, and the parent interacts with the software to receive psychoeducation and modeling of target skills. The provider and parent then work together to practice the targeted skills until mastery is achieved. Initial findings from ongoing research of both of these strategies indicate that they show potential for improving engagement and use of positive parenting skills for parents and ease of implementation for providers. Future directions for technology enhancements in SafeCare are also presented.
Strategic planning of educational informatization is both an important part of education strategic planning and the program of leading the development of educational informatization. Scientific and rational educational informatization planning plays an important role in promoting sustainable development and producing function of educational informatization. The article analyzes the present situation that educational informatization planning research lags behind practice and the elements of educational informatization planning, summarizes the theory and method of educational informatization planning, and puts forward what should be focused on in future research on educational informatization planning.%教育信息化战略规划是教育战略规划的重要组成部分,是引领教育信息化发展的纲领.科学合理的教育信息化规划对于促进教育信息化可持续发展,发挥教育信息化的功能效益具有重要的作用.文章分析了我国教育信息化规划研究落后于实践的现状,分析了教育信息化规划的构成要素,归纳了教育信息化规划的理论与方法,提出了未来教育信息化规划研究应关注的内容.
The content of undergraduate physics programs has not changed appreciably in 50 years, however, the jobs our students take have changed dramatically. Preparing students for careers they are likely to encounter requires physics programs to rethink and in some cases retool to provide an education that will not only educate an individual in the habits of mind and keen sense of how to solve complex technical problems, but also what related skills they will need to be effective in those careers. Do you teach your student how to read or create a budget? How about dealing with a low-performing member of an R&D team? This talk will explore driving forces behind this report, potential implications for physics departments, and practical steps faculty members can take to continue to consider improvements in experiences for our students. This work is supported in part by the National Science Foundation (NSF-1540570).
Fronstin, Paul; Roebuck, M Christopher
This paper analyzes data from a large employer that enhanced financial incentives to encourage participation in its workplace wellness programs. It examines, first, the effect of financial incentives on wellness program participation, and second, it estimates the impact of wellness program participation on utilization of health care services and spending. The Patient Protection and Affordable Care Act of 2010 (PPACA) allows employers to provide financial incentives of as much as 30 percent of the total cost of coverage when tied to participation in a wellness program. Participation in health risk assessments (HRAs) increased by 50 percentage points among members of unions that bargained in the incentive, and increased 22 percentage points among non-union employees. Participation in the biometric screening program increased 55 percentage points when financial incentives were provided. Biometric screenings led to an average increase of 0.31 annual prescription drug fills, with related spending higher by $56 per member per year. Otherwise, no significant effects of participation in HRAs or biometric screenings on utilization of health care services and spending were found. The largest increase in medication utilization as a result of biometric screening was for statins, which are widely used to treat high cholesterol. This therapeutic class accounted for one-sixth of the overall increase in prescription drug utilization. Second were antidepressants, followed by ACE inhibitors (for hypertension), and thyroid hormones (for hypothyroidism). Biometric screening also led to significantly higher utilization of biologic response modifiers and immunosuppressants. These specialty medications are used to treat autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis, and are relatively expensive compared with non-specialty medications. The added spending associated with the combined increase in fills of 0.02 was $27 per member per year--about one-half of the
Li, Ian; Froehlich, Jon; Larsen, Jakob Eg
Personal informatics is a class of systems that help people collect personal information to improve selfknowledge. Improving self-knowledge can foster selfinsight and promote positive behaviors, such as healthy living and energy conservation. The development of personal informatics applications p...
A. Hasman; R. Haux
Objectives: Modeling is a significant part of research, education and practice in biomedical and health informatics. Our objective was to explore, which types of models of processes are used in current biomedical/health informatics research, as reflected in publications of scientific journals in thi
Fei; XUE; Lina; WANG
Through the analyses of several typical paradigms of informatization in the countryside,the status of informatization in the countryside and some unresolved issues were studied. A new way was proposed to develop rural information with embedded mobile phone terminal,and to explore an inexpensive and efficient information services paradigm for the future development in the countryside.
Full Text Available Background: Pathology informatics is both emerging as a distinct subspecialty and simultaneously becoming deeply integrated within the breadth of pathology practice. As specialists, pathology informaticians need a broad skill set, including aptitude with information fundamentals, information systems, workflow and process, and governance and management. Currently, many of those seeking training in pathology informatics additionally choose training in a second subspecialty. Combining pathology informatics training with molecular pathology is a natural extension, as molecular pathology is a subspecialty with high potential for application of modern biomedical informatics techniques. Methods and Results: Pathology informatics and molecular pathology fellows and faculty evaluated the current fellowship program′s core curriculum topics and subtopics for relevance to molecular pathology. By focusing on the overlap between the two disciplines, a structured curriculum consisting of didactics, operational rotations, and research projects was developed for those fellows interested in both pathology informatics and molecular pathology. Conclusions: The scope of molecular diagnostics is expanding dramatically as technology advances and our understanding of disease extends to the genetic level. Here, we highlight many of the informatics challenges facing molecular pathology today, and outline specific informatics principles necessary for the training of future molecular pathologists.
Mui, A C
This article examines the long-term care service system in the United States, its problems, and an improved long-term care model. Problematic quality of care in institutional settings and fragmentation of service coordination in community-based settings are two major issues in the traditional long-term care system. The Program of All-Inclusive Care for the Elderly (PACE) has been emerging since the 1970s to address these issues, particularly because most frail elders prefer community-based to institutional care. The Balanced Budget Act of 1997 made PACE a permanent provider type under Medicare and granted states the option of paying a capitation rate for PACE services under Medicaid. The PACE model is a managed long-term care system that provides frail elders alternatives to nursing home life. The PACE program's primary goals are to maximize each frail elderly participant's autonomy and continued community residence, and to provide quality care at a lower cost than Medicare, Medicaid, and private-pay participants, who pay in the traditional fee-for-service system. In exchange for Medicare and Medicaid fixed monthly payments for each participating frail elder, PACE service systems provide a continuum of long-term care services, including hospital and nursing home care, and bear full financial risk. Integration of acute and long-term care services in the PACE model allows care of frail elders with multiple problems by a single service organization that can provide a full range of services. PACE's range of services and organizational features are discussed.
Full Text Available Malnutrisi pada balita masih merupakan permasalahan di Indonesia termasuk di Daerah Istimewa Yogyakarta. Berdasarkan indikator berat badan menurut tinggi badan, 2,6% balita mengalami malnutrisi akut berat. Pada beberapa dekade terakhir, telah terjadi pergeseran paradigma dalam penanganan balita malnutrisi, yang sebelumnya berbasis pendekatan fasilitas kesehatan bergeser menjadi pendekatan berbasis komunitas. Tujuan penelitian ini adalah untuk menganalisis pengaruh program home care terhadap peningkatan status gizi balita malnutrisi pada anak usia 6-60 bulan. Penelitian menggunakan desain kuasi eksperimen dengan pretest dan posttest control group melalui tiga tahap pendampingan yaitu intensif, mandiri, dan penguatan dengan pendekatan asuhan keperawatan. Sampel adalah 56 balita malnutrisi akut di dua wilayah, yaitu 33 balita di Kota Yogyakarta (eksperimen dan 23 balita di Kabupaten Sleman (kontrol dengan teknik pengambilan sampel yaitu purposive sampling. Intervensi home care diberikan selama tiga 3 bulan (Januari sampai Maret 2013. Hasil penelitian menunjukkan setelah program home care, terjadi peningkatan yang signifikan pada status gizi balita (p < 0,05. Pada akhir intervensi, terjadi penurunan kejadian malnutrisi akut berat dari 100% menjadi 56,7% (p < 0,05. Improving Nutritional Status of Children with Severe Acute Malnutrition Through Home Care Program Children undernutrition is still an issue in Indonesia, including in the Special Region of Yogyakarta. Based on weight for height indicator, 2.6% children experience severe acute malnutrition. In the last few decades, there has been a paradigm shift in the management of acute malnutrition from a facility- based to community-centered approach. The purpose of this study was to analyze the effect of home care intervention on the improvement of nutritional status of severe acute malnutrition children aged 6-60 months. This study was designed with quasi-experimental and pretest-posttest control
Abdullah M Al-Wahbi
Full Text Available Abdullah M Al-WahbiDepartment of Surgery, King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences, Riyahd, Kingdom of Saudi ArabiaBackground: Diabetic foot complications are a leading cause of lower extremity amputation. With the increasing incidence of diabetes mellitus in the Arab world, specifically in the Kingdom of Saudi Arabia, the rate of amputation will rise significantly. A diabetic foot care program was implemented at King Abdulaziz Medical City in Riyadh, Saudi Arabia, in 2002. The program was directed at health care staff and patients to increase their awareness about diabetic foot care and prevention of complications. The purpose of this study was to perform a primary evaluation of the program’s impact on the rate of lower extremity amputation due to diabetic foot complications.Method: This pilot study was the first analysis of the diabetic foot care program and examined two groups of participants for comparison, ie, a “before” group having had diabetic foot ulcers managed between 1983, when the hospital was first established, and 2002 when the program began and an “after group” having had foot ulcers managed between 2002 and 2004, in the program’s initial phase. A total of 41 charts were randomly chosen retrospectively. A data sheet containing age, gender, medical data, and the presentation, management, and outcome of diabetic foot cases was used for the analysis.Results: The before group contained 20 patients (17 males and the after group contained 21 patients (16 males. There was no difference between the two groups with regard to age and comorbidities. The rate of amputation was 70% in the before group and 61.9% in the after group. There was a decrease in the percentage of toe amputation in the after group and an increase in the percentage of below-knee amputation in the before group. However, these changes were not significant.Conclusion: The program, although evaluated at an early
Özyer, Tansel; Rokne, Jon; Khoury, Suheil
Crime, terrorism and security are in the forefront of current societal concerns. This edited volume presents research based on social network techniques showing how data from crime and terror networks can be analyzed and how information can be extracted. The topics covered include crime data mining and visualization; organized crime detection; crime network visualization; computational criminology; aspects of terror network analyses and threat prediction including cyberterrorism and the related area of dark web; privacy issues in social networks; security informatics; graph algorithms for soci
Kamal, Jyoti; Liu, Jianhua; Ostrander, Michael; Santangelo, Jennifer; Dyta, Ravi; Rogers, Patrick; Mekhjian, Hagop S
Since its inception in 1997, the IW (Information Warehouse) at the Ohio State University Medical Center (OSUMC) has gradually transformed itself from a single purpose business decision support system to a comprehensive informatics platform supporting basic, clinical, and translational research. The IW today is the combination of four integrated components: a clinical data repository containing over a million patients; a research data repository housing various research specific data; an application development platform for building business and research enabling applications; a business intelligence environment assisting in reporting in all function areas. The IW is structured and encoded using standard terminologies such as SNOMED-CT, ICD, and CPT. The IW is an important component of OSUMC's Clinical and Translational Science Award (CTSA) informatics program.
Engel, Nora; Pant Pai, Nitika
Point-of-care (POC) testing in communities, home settings and primary healthcare centers plays an important role in cutting delays in HIV diagnosis and in the uptake of voluntary testing and counseling. Qualitative research methods have important potential to overcome the current challenges in expanding HIV POC testing programs and strategies, by examining the diagnostic processes, complex inter-relationships and patterns involved in making POC diagnostics work in real-world settings. This article reviews existing qualitative studies on POC testing strategies and programs for HIV. Qualitative research on POC diagnostics around the uptake of POC tests, the actual diagnostic and testing processes involved, the influence of POC tests on clinical decision-making, communication of decisions and decisions exercised by patients are limited. Equally limited are studies that explore adaptation of POC programs to various socio-cultural contexts. More qualitative research is needed to inform test developers, funders and policymakers.
Full Text Available William R Hersh,1 Paul N Gorman,1 Frances E Biagioli,2 Vishnu Mohan,1 Jeffrey A Gold,3 George C Mejicano4 1Department of Medical Informatics and Clinical Epidemiology, 2Department of Family Medicine, 3Department of Medicine, 4School of Medicine, Oregon Health & Science University, Portland, OR, USA Abstract: Physicians in the 21st century will increasingly interact in diverse ways with information systems, requiring competence in many aspects of clinical informatics. In recent years, many medical school curricula have added content in information retrieval (search and basic use of the electronic health record. However, this omits the growing number of other ways that physicians are interacting with information that includes activities such as clinical decision support, quality measurement and improvement, personal health records, telemedicine, and personalized medicine. We describe a process whereby six faculty members representing different perspectives came together to define competencies in clinical informatics for a curriculum transformation process occurring at Oregon Health & Science University. From the broad competencies, we also developed specific learning objectives and milestones, an implementation schedule, and mapping to general competency domains. We present our work to encourage debate and refinement as well as facilitate evaluation in this area. Keywords: curriculum transformation, clinical decision support, patient safety, health care quality, patient engagement
James Neil B. Mendoza
Full Text Available Nursing Informatics is becoming a trend in the nursing education sector and health care workforce. Belonging to the academic performance of the students, steps are necessary to improve it as performance and retention were becoming a great issue for educators, students and the nation. As the student performs, all academic measures were recorded into the database system, over the years it accumulated to a large amount. Data were forgotten, archived at the least. Then came educational data mining, with all its ability. Unknown and hidden data patterns of Nursing Informatics and accompanying subjects were extracted and analyzed using the same database grading system of Omar Al-Mukhtar University College of Nursing known as OMUCON-GSv1. Getting started with mining by employing database management methods and implementations like Structured Query Language to form a query, filter, pivot table and pivot chart, the system and the research generated valuable findings. The result of the study showed a favorable academic performance by the students of nursing and so with the ranking they got for Nursing Informatics. Overall the OMUCON-GSv1 can generate helpful and meaningful data as it promoted simple educational data mining. A vital element in the improvement of quality education for the College. Further study and advance data mining approach were recommended to greatly improve the outcome.
I. L. Livshits
Full Text Available Retrospective structure analysis of the European scientific and technological platforms – photonics, nanomaterials and photovoltaics – is represented from the point of view of their structure, interpenetration of subjects and dynamics of the changes which have occurred over the last ten years. Geoinformation component of the European optical education is analyzed. Criteria of research and the ontological models, giving the possibility to reveal correlations between development of scientific researches and industrial applications, on the one hand, and dynamics of educational programs on optics, photonics and optical informatics are described. Data on quantitative and high-quality changes in educational programs and appropriate academic degrees on the corresponding training directions are submitted. The material is illustrated with fragments of the associative card "Modern Directions of Researches in the Field of Optics, Photonics and Optical Information" and the conceptual card "European Scientific and Technological Platforms". The tag cloud is given in lower ontological level for two concrete subject domains of "Lasers" and "Optics Communications". Convergent and divergent trends, characteristic for the last decade development of optics, photonics and optical informatics in Europe are formulated. The main trends are: the directions and rates of the market development correlate with geoinformation data on the European scientific and educational tendencies; telecommunications and information technologies are dominating spheres of knowledge application and competences of the European experts in optics, photonics and optical informatics; the ontological structure of knowledge bases in the field of biophotonics, polymeric optics, photon crystals and "clever" optical metamaterials becomes more branched; a number of conceptual ontological knots in optics, photonics and optical informatics are gradually losing their relevance, being replaced by new
Madden, Karen A; Waldo, Mary; Cleeter, Deborah
There is an increasing volume of literature supporting the Program of All-inclusive Care for the Elderly (PACE) as an innovative model of health care delivery for frail seniors. Registered Nurses (RN) hold an essential position among the PACE interdisciplinary teams (IDT) which serve as the foundational practice approach to patient care. There are currently 97 PACE programs in 31 states. Federal and respective state laws provide comprehensive specifications for IDT composition, minimum qualification of team members and services provided. The role of the RN is not fully defined beyond the requirement of periodic assessments. The intent of this study was to explore and describe the role of the nurse in PACE and to compare nursing care delivery models. Focused interviews and survey results show great variation in nursing roles as well as some common themes among nursing leaders for the vision of PACE nurses.
Eva Ekvall Hansson
Full Text Available Eva Ekvall Hansson1, Eva Håkansson2, Annelie Raushed2, Anders Håkansson1 1Lund University, Department of Clinical Sciences in Malmö/General Practice, Malmö, Sweden; 2Primary Health Care Malmö, SwedenObjective: To describe a multidisciplinary program, given by an occupational therapist and a physiotherapist, for patients with stress-related disease in primary health care and to measure the effect of this program in terms of self-perceived health, degree of burnout, physical activity, symptoms, recreational activities, and psychological and physical well-being.Method: Retrospective study.Results: At measures after three months, the thirteen patients included in this study had improved in self-estimated health, measured with EuroQol-5D Visual Analogue Scale (p = 0.000, and in degree of burnout, measured with the Shirom–Melamed Burnout Questionnaire (p = 0.001. There was also a decrease in presence of headache, in physical activity and in satisfaction with leisure time, although not statistically significant. After six months, the improvements remained for all measures except physical activity. The patients were also satisfied with the program to a high degree, measured with Client Satisfaction Questionnaire (median 3.7.Conclusion: This descriptive study shows that a stress-management program, provided by a team including an occupational therapist and a physiotherapist in primary health care, is both feasible and effective in terms of self-estimated health, degree of burnout, and patient satisfaction. Keywords: stress-related health, burnout, occupational therapy, physiotherapy
Gupta, Abha A; Papadakos, Janet K; Jones, Jennifer M; Amin, Leila; Chang, Eugene K; Korenblum, Chana; Santa Mina, Daniel; McCabe, Lianne; Mitchell, Laura; Giuliani, Meredith E
Literature regarding the development of adolescent and young adult (AYA) cancer programs has been dominantly informed by pediatric centers and practitioners. However, the majority of young adults are seen and treated at adult cancer centers, in which cancer volumes afford the development of innovative supportive care services. Although the supportive care services in adult cancer centers are helpful to AYAs, some of the most prominent and distinct issues faced by AYAs are not adequately addressed through these services alone. This article describes how the AYA Program at Princess Margaret Cancer Centre has collaborated with existing supportive care services in addition to supplying its own unique services to meet the comprehensive needs of AYAs in the domains of: symptom management (sexuality and fatigue), behavior modification (return to work and exercise), and health services (advanced cancer and survivorship). These collaborations are augmented by patient education interventions and timely referrals. The objective of this article was to assist other centers in expanding existing services to address the needs of AYA patients with cancer.
Berg, Gregory D; Leary, Fredric; Medina, Wendie; Donnelly, Shawn; Warnick, Kathleen
The objective was to estimate clinical metric and medication persistency impacts of a care management program. The data sources were Medicaid administrative claims for a sample population of 32,334 noninstitutionalized Medicaid-only aged, blind, or disabled patients with diagnosed conditions of asthma, coronary artery disease, chronic obstructive pulmonary disease, diabetes, or heart failure between 2005 and 2009. Multivariate regression analysis was used to test the hypothesis that exposure to a care management intervention increased the likelihood of having the appropriate medication or procedures performed, as well as increased medication persistency. Statistically significant clinical metric improvements occurred in each of the 5 conditions studied. Increased medication persistency was found for beta-blocker medication for members with coronary artery disease, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and diuretic medications for members with heart failure, bronchodilator and corticosteroid medications for members with chronic obstructive pulmonary disease, and aspirin/antiplatelet medications for members with diabetes. This study demonstrates that a care management program increases the likelihood of having an appropriate medication dispensed and/or an appropriate clinical test performed, as well as increased likelihood of medication persistency, in people with chronic conditions.
Martín-Calero, M J; Machuca, M; Murillo, M D; Cansino, J; Gastelurrutia, M A; Faus, M J
Pharmaceutical care started in the nineties in the United States and has rapidly extended in many other countries. Although there are different trends, such as clinical pharmacy services, cognitive services, medication management, medication review, they all share the same philosophy and objectives, namely "the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient's quality of life". To attain these objectives, a pharmaceutical care process has to be followed point-by-point in order to detect possible medication-related problems. Furthermore, pharmacists have to work together with patients, and ultimately with physicians to establish a care plan. This methodology requires basic skills of documentation and communication and therefore, it is important to establish implementation programs aimed at community-, hospital-, and consultant pharmacists, and to consider PC as a basic element of University teaching programs and postgraduate studies. Moreover, there are still barriers that hinder the provision of this service and have to be overcome. In this article, we have revised the implementation process and the existing projects in many countries and we conclude that despite the enormous amount of work, there is still much to be done from sides of Administration and pharmacists themselves.
Hopman, P.; Bruijn, S.R. de; Forjaz, M.J.; Rodriguez-Blazquez, C.; Tonnara, G.; Lemmens, L.C.; Onder, G.; Baan, C.A.; Rijken, M.
Objective: To describe comprehensive care programs targeting multimorbid and/or frail patients and to estimate their effectiveness regarding improvement of patient and caregiver related outcomes, healthcare utilization and costs. Methods: Systematic search in six electronic databases for scientific
Full Text Available The Transfusion Medicine Service (TMS covers diverse clinical and laboratory-based services that must be delivered with accuracy, efficiency and reliability. TMS oversight is shared by multiple regulatory agencies that cover product manufacturing and validation standards geared toward patient safety. These demands present significant informatics challenges. Over the past few decades, TMS information systems have improved to better handle blood product manufacturing, inventory, delivery, tracking and documentation. Audit trails and access to electronic databases have greatly facilitated product traceability and biovigilance efforts. Modern blood bank computing has enabled novel applications such as the electronic crossmatch, kiosk-based blood product delivery systems, and self-administered computerized blood donor interview and eligibility determination. With increasing use of barcoding technology, there has been a marked improvement in patient and specimen identification. Moreover, the emergence of national and international labeling standards such as ISBT 128 have facilitated the availability, movement and tracking of blood products across national and international boundaries. TMS has only recently begun to leverage the electronic medical record to address quality issues in transfusion practice and promote standardized documentation within institutions. With improved technology, future growth is expected in blood bank automation and product labeling with applications such as radio frequency identification devices. This article reviews several of these key informatics issues relevant to the contemporary practice of TMS.
Full Text Available Internet, cloud computing, social networks and mobile technology, all facilitate information transfer. Healthcare professionals, physicians and patients can use informatic devices in order to simplify their access to medical information, to streamline testing, and to understand clinical results. The use of computers and software facilitate doctor-patient interactions by optimizing communication and information flow. However, digital interfaces also increase the risks that information specialists use information without fully complying with ethical principles and laws in force. Our premise is that these information specialists should: 1 be informed of the rights, duties, and responsibilities linked to their profession and laws in force; 2 have guidelines and ethical tutoring on what they need to do in order to avoid or prevent conflict or misconduct; 3 have renewed specific training on how to interpret and translate legal frameworks into internal rules and standards of good practice. The purpose of this paper was: 1 to familiarize professionals who work in healthcare informatics with the ethical and legal issues related to their work; 2 to provide information about codes of ethics and legal regulations concerning this specific area; 3 to summarize some risks linked to wrong or inadequate use of patient information, such as medical, genetic, or personal data.
Informatics teaching in undergraduate nursing programs at Brazilian public institutions Enseñanza de informática en la graduación en enfermería de instituciones públicas Brasileñas Ensino da informática na graduação em Enfermagem de instituições públicas Brasileiras
Luiz Miguel Picelli Sanches
Full Text Available This descriptive study aimed to verify the inclusion of subjects about informatics in undergraduate nursing programs at Brazilian (state and federal public education institutions. The programs were located through the e-MEC system. The Internet was used to search for the curricula of the campuses offering the nursing program and identify subjects related to informatics. Eighty-one higher education institutions and 123 campuses were located. Only 100 campuses provided the curriculum on the Internet, 35 of which offered the subject. The highest proportion occurred in the Northeast (46.1% and the lowest in the North (8.6%. The subject is mostly offered as an elective discipline (57% in the first and second year (80%, with an average workload of 47 classroom hours. The low supply of this undergraduate subject goes against job market trends and the National Curriculum Guidelines for Undergraduate Nursing Programs.Este estudio descriptivo objetivó verificar la inclusión de disciplinas relacionadas a la informática en los cursos de graduación en enfermería de instituciones de enseñanza superior federales y estatales brasileñas. Los cursos de graduación fueron localizados por el sistema e-MEC. La búsqueda del plan de estudios de los campus que ofrecían el curso de enfermería fue realizada por la internet, identificando disciplinas relacionadas a la informática. Fueron localizadas 81 instituciones de enseñanza superior y 123 campus. Apenas 100 campus disponen el plan de estudios en la internet y, de estos, 35 campus ofrecían la disciplina. La mayor proporción ocurrió en la región noreste (46,1% y, la menor, en la región norte (8,6%. La disciplina es ofrecida con mayor frecuencia como electiva (57%, en el primero y segundo año del curso (80%, con carga horaria promedio de 47 horas-clase. La baja oferta de la disciplina en la graduación contraría las tendencias del mercado de trabajo y de las Directrices Curriculares Nacionales del
Li, Jingyi; Finkelstein, Joseph
Qualitative methodology is gaining popularity in medical informatics research. We performed a systematic review of published studies, between 1994 and 2005, in two major medical informatics journals: JAMIA and International Journal of Medical Informatics (IJMI). The goal is to describe the emerging trends of using qualitative methodology in medical informatics research and to access the methodological quality of these qualitative studies.
Full Text Available Purpose: This study is to examine the effects of skills training program named healthy parenting program on first time father skills. The skills are baby bath and umbilical cord care, baby blanket, burping and handling the baby, baby lullaby and replace baby clothes.Method: This is a quasi experiment study. Sampling technique is purposive sampling with 30 first time father with 0-28 days new born baby. Sample equally assigned into experimental and control groups. Subject in experimental group received healthy parenting skills program, while control group was given routine care only. The instrument is observation guideline. Wilcoxon and Man Whitney Test are used to analyze data.Result: Father’ skills in experimental group after receiving the program are statistically increased from before the program (bathing and umbilical cord care, baby blanket, baby burping, baby handling, baby lullaby, replace baby clothes.Conclusion: Father’ skills in experimental group after receiving the program are statistically increased over control group (bathing and umbilical cord care, baby blanket skill, baby burping, baby handling, baby lullaby, replace baby clothes. Suggestions are the educational efforts by health-care professionals could beneficially be directed toward fathers throughout prenatal and postpartum periods. Health center in Indonesia should initiate class program directed to father in part of program in reducing neonates and post partum mothers health problems.
Cabassa, Leopoldo J; Gomes, Arminda P; Lewis-Fernández, Roberto
Health care manager interventions can improve the physical health of people with serious mental illness (SMI). In this study, we used concepts from the theory of diffusion of innovations, the consolidated framework for implementation research and a taxonomy of implementation strategies to examine stakeholders' recommendations for implementing a health care manager intervention in public mental health clinics serving Hispanics with SMI. A purposive sample of 20 stakeholders was recruited from mental health agencies, primary care clinics, and consumer advocacy organizations. We presented participants a vignette describing a health care manager intervention and used semistructured qualitative interviews to examine their views and recommendations for implementing this program. Interviews were recorded, professionally transcribed, and content analyzed. We found that a blend of implementation strategies that demonstrates local relative advantage, addresses cost concerns, and enhances compatibility to organizations and the client population is critical for moving health care manager interventions into practice.
Rodrigues, Maísa Paulino; de Lima, Kenio Costa; Roncalli, Angelo Giuseppe
This study examines the core and outlying representational elements of healthcare constructed by Family Healthcare Program teams in Natal, Brazil, using the theory of social representations and the central core theory. The sample consisted of ninety healthcare practitioners working with this Program, with data collected through free word association, a questionnaire and focus groups. The core representation consists of attention/love and comfort, disclosing different understandings and showing that accumulated knowledge is supported by a view that is close to care-giving. However, traditional values and trivial connotations are maintained, hindering the implementation of more effective interventions in by this Program. The core composition indicated that any capacity-building efforts that try to modify attitudes - and thus the daily practice of these practitioners - must assign high priority to discussions on redefining these elements of attention/love and comfort. They must consider the set of mental, emotional, and practical elaborations as well as explanations arising from daily life that are introduced into the constitution of the social representations under examination, influencing choices and shaping the strategies used by practitioners to provide care.
Jahromi, Vahid Kohpeima; Mehrolhassani, Mohammad Hossein; Dehnavieh, Reza; Anari, Hosein Saberi
Background: A responsibility of the family physician (FP) and one of the four aspects of the delivery of primary care services is continuity of care (COC). This study aimed to determine the COC of health care in urban health centers. Methods: Between September 2015 and March 2016, we conducted a cross-sectional study using Primary Care Evaluation Tool questionnaires with multistage stratified cluster sample of FPs (n = 141) and patients (n = 710) in two provinces in Iran, Fars and Mazandaran. The questionnaires contained essential dimensions of COC: Informational, interpersonal, and longitudinal COC. Results: Almost all FPs had a computer. The FPs hadn’t kept their patients’ medical records routinely. The software had some problems, so the FPs couldn’t produce lists of patients based on their health risk and they couldn’t monitor their population. Almost 88% of FPs have written referral letters for all referred patients but 57% of them got medical feedback from specialists. About 80% of patients’ consultation times were up to 10 min. 29% of FPs knew the past problems and illnesses of the patients. From 40% to 50% of the patients stated that their FPs asked them for their desire about prescribed medicine and gave clear explanation about their illnesses. On average, patients visited their doctor 5.5 times during the previous year. Generally, patients and FPs in Mazandaran could summarize their experiences better than Fars in most topics of COC. Conclusions: It seems that after 3 years of using urban FP program in two pilot provinces, there were still some problems in COC. Strengthen software program, introducing incentives for FPs, and promoting patients’ responsibility can be used by policy-makers when they seek to enhance COC. PMID:28299031
José Ignacio BENITO-OREJAS
Full Text Available Introduction and objective: Hearing loss is the most prevalent sensory deficiency at birth. Even though, coordinating a program for early detection and care may seem simple tasks, they are not so when it takes responsibility for the negative impact that a delay in the identification or treatment, can cause in the linguistic and educational development of the child. With this review, we provide an overview of the commitment involved in the practice of this task. Method: We analyze functions assigned to the supervisor of a "Children's Program of Hearing Loss", which are set in the program of the Community of Castilla y León, that are a reflection of other communities and countries, because they belong to an international consensus backed by different regulatory organisms, which in Spain corresponds to the Commission for the Early Detection of Hearing Loss (CODEPEH. Results: The coordinator of a "Children's Program of Hearing Loss" should monitor the early identification of the new born with hearing impairment, ensure early diagnosis and treatment, ask for specific tests and assess the success of the intervention. This process focuses on the family as a key driver of the project. The institutional and administrative support should be at the service of this activity. Conclusions: Take over a "Children's Program of Hearing Loss" implies a global conception, which consists of establishing a preventive control of hearing health of the child, that increases the complexity of their development.
Park, Seung; Parwani, Anil V.; Aller, Raymond D.; Banach, Lech; Becich, Michael J.; Borkenfeld, Stephan; Carter, Alexis B.; Friedman, Bruce A.; Rojo, Marcial Garcia; Georgiou, Andrew; Kayser, Gian; Kayser, Klaus; Legg, Michael; Naugler, Christopher; Sawai, Takashi; Weiner, Hal; Winsten, Dennis; Pantanowitz, Liron
Pathology informatics has evolved to varying levels around the world. The history of pathology informatics in different countries is a tale with many dimensions. At first glance, it is the familiar story of individuals solving problems that arise in their clinical practice to enhance efficiency, better manage (e.g., digitize) laboratory information, as well as exploit emerging information technologies. Under the surface, however, lie powerful resource, regulatory, and societal forces that helped shape our discipline into what it is today. In this monograph, for the first time in the history of our discipline, we collectively perform a global review of the field of pathology informatics. In doing so, we illustrate how general far-reaching trends such as the advent of computers, the Internet and digital imaging have affected pathology informatics in the world at large. Major drivers in the field included the need for pathologists to comply with national standards for health information technology and telepathology applications to meet the scarcity of pathology services and trained people in certain countries. Following trials by a multitude of investigators, not all of them successful, it is apparent that innovation alone did not assure the success of many informatics tools and solutions. Common, ongoing barriers to the widespread adoption of informatics devices include poor information technology infrastructure in undeveloped areas, the cost of technology, and regulatory issues. This review offers a deeper understanding of how pathology informatics historically developed and provides insights into what the promising future might hold. PMID:23869286
Advanced practice nurses are involved in many aspects of program development as part of their roles. This can involve such things as developing programs for staff and family education, organizing system-wide quality assurance programs, or implementing new care programs. One unique aspect of the advanced practice nurse's role is the ability to serve as a change agent and implement new models of care. Although all advanced practice nurses can be involved in program development, the role of the Clinical Nurse Specialist lends itself to devoting dedicated services for implementing programmatic change in the clinical setting. This article describes the role of the Clinical Nurse Specialist in implementing an evidence-based, fast-track postanesthesia care unit.
Full Text Available Gail E Bond,1 Laurie Rechholtz,1 Christina Bosa,1 Celine Impert,1,2 Sara Barker21College of Nursing, Seattle University, Seattle WA, USA; 2Sea Mar Community Health Center, Seattle, WA, USAProblem statement: Unprecedented consumption of health care resources in the USA coupled with increasing rates of chronic disease has fueled pursuit of improved models of health care delivery. The Chronic Care Model provides an organizational framework for chronic care management and practice improvement. Sea Mar, a community health care organization in Washington state, implemented the Chronic Care Model, but has not evaluated the outcomes related to provider and staff satisfaction. The specific aim of this project was to evaluate the effectiveness of the Chronic Care Model with the addition of the Chronic Care Coordinator role.Approach: A descriptive method was used, which incorporated quantitative, and qualitative data from providers and clinic staff collected through a Web-based survey consisting of Likert-type questions sent via an electronic link.Results: This evaluation identified the strengths of and barriers to the chronic care model with a focus on provider and staff satisfaction regarding patient care since the addition of the Chronic Care Coordinator role. We found a high appreciation (94% and acceptance of the role; 80% agreed that the Chronic Care Coordinator was well-integrated into clinic operations. Major strengths of the program included more patient education, better follow-up, and improved team communications. Barriers to success included limited provider access, confusion regarding role expectations of the Chronic Care Coordinator, inconsistent communications, and Chronic Care Coordinator turnover.Conclusions/recommendations: Our findings help to validate the importance of community health organizations such as Sea Mar, the utility of the chronic care model, and the potential value for specific roles such as the Chronic Care Coordinator to
Ma, Kevin; Liu, Joseph; Zhang, Xuejun; Lerner, Alex; Shiroishi, Mark; Amezcua, Lilyana; Liu, Brent
We have designed and developed a multiple sclerosis eFolder system for patient data storage, image viewing, and automatic lesion quantification results stored in DICOM-SR format. The web-based system aims to be integrated in DICOM-compliant clinical and research environments to aid clinicians in patient treatments and data analysis. The system needs to quantify lesion volumes, identify and register lesion locations to track shifts in volume and quantity of lesions in a longitudinal study. In order to perform lesion registration, we have developed a brain warping and normalizing methodology using Statistical Parametric Mapping (SPM) MATLAB toolkit for brain MRI. Patients' brain MR images are processed via SPM's normalization processes, and the brain images are analyzed and warped according to the tissue probability map. Lesion identification and contouring are completed by neuroradiologists, and lesion volume quantification is completed by the eFolder's CAD program. Lesion comparison results in longitudinal studies show key growth and active regions. The results display successful lesion registration and tracking over a longitudinal study. Lesion change results are graphically represented in the web-based user interface, and users are able to correlate patient progress and changes in the MRI images. The completed lesion and disease tracking tool would enable the eFolder to provide complete patient profiles, improve the efficiency of patient care, and perform comprehensive data analysis through an integrated imaging informatics system.
Karp, Peter D; Latendresse, Mario; Paley, Suzanne M; Krummenacker, Markus; Ong, Quang D; Billington, Richard; Kothari, Anamika; Weaver, Daniel; Lee, Thomas; Subhraveti, Pallavi; Spaulding, Aaron; Fulcher, Carol; Keseler, Ingrid M; Caspi, Ron
Pathway Tools is a bioinformatics software environment with a broad set of capabilities. The software provides genome-informatics tools such as a genome browser, sequence alignments, a genome-variant analyzer and comparative-genomics operations. It offers metabolic-informatics tools, such as metabolic reconstruction, quantitative metabolic modeling, prediction of reaction atom mappings and metabolic route search. Pathway Tools also provides regulatory-informatics tools, such as the ability to represent and visualize a wide range of regulatory interactions. This article outlines the advances in Pathway Tools in the past 5 years. Major additions include components for metabolic modeling, metabolic route search, computation of atom mappings and estimation of compound Gibbs free energies of formation; addition of editors for signaling pathways, for genome sequences and for cellular architecture; storage of gene essentiality data and phenotype data; display of multiple alignments, and of signaling and electron-transport pathways; and development of Python and web-services application programming interfaces. Scientists around the world have created more than 9800 Pathway/Genome Databases by using Pathway Tools, many of which are curated databases for important model organisms.
Jensen, Camilla Birgitte Falk
to personal informatics systems, and propose an approach to design cognitive interfaces, which considers both users’ motivations, needs, and goals. In this thesis I propose a new personal informatics framework, the feedback loop, which incorporates lean agile design principles. Including hierarchical modeling....... For instance, examining emotional responses to pleasant and unpleasant media content from brain activity, reveals the large amount of data and extensive analysis required to apply this to future personal informatics systems. In addition we analyse challenges related to temporal aspects of the feedback loop...
To achieve a cursory review of the competencies necessary for acquire a successful career in a competitive job market, the panel will bring together leaders from renowned academic, successful health corporations, and international leaders in nursing informatics to the table for discussion, dialogue, and make recommendations. Panelists will reflect on their experiences within the different types of informatics organizations and present some of the current challenges when educating skillful professionals. The panel will provide personal experiences, thoughts, and advice on the competencies development in nursing informatics from their lens.
Shaalan, Khaled; Gaber, Tarek; Azar, Ahmad; Tolba, M
This book gathers the proceedings of the 2nd International Conference on Advanced Intelligent Systems and Informatics (AISI2016), which took place in Cairo, Egypt during October 24–26, 2016. This international interdisciplinary conference, which highlighted essential research and developments in the field of informatics and intelligent systems, was organized by the Scientific Research Group in Egypt (SRGE) and sponsored by the IEEE Computational Intelligence Society (Egypt chapter) and the IEEE Robotics and Automation Society (Egypt Chapter). The book’s content is divided into four main sections: Intelligent Language Processing, Intelligent Systems, Intelligent Robotics Systems, and Informatics.
Morris, Theodore Allan
Previous bibliometric analyses of Medical Informatics' internal structure used MEDLINE records as the unit of study. EMBASE, a product of Excerpta Medica, carries a wider international scope and offers complementary retrieval results to MEDLINE. Since much medical informatics critical thinking originated abroad and migrated to North America, this difference in coverage may also indicate a different perspective of "what constitutes medical informatics." Using traditional bibliometric and multivariate data analysis techniques, the present work examines EMBASE indexing records for the same 1995-1999 time frame as earlier MEDLINE studies to identify and compare structural features of the field.
Gupta, Vivek K.; Gupta, Veer B.
Rapid advances in ocular diagnostic approaches and emerging links of pathological changes in the eye with systemic disorders have widened the scope of optometry as the front line of eye health care. Expanding professional requirements stipulate that optometry students get a meticulous training in relevant information and communication technologies (ICT) and various bioinformatics and health informatics software to meet current and future challenges. Greater incorporation of ICT approaches in ...
Lemke, Heinz U.; Ratib, Osman M.; Horii, Steven C.
This review paper is based on the 2004 UCLA Seminar on Imaging and Informatics (http://www.radnet.ucla.edu/Arrowhead2004/) which is a joint endeavour between the UCLA and the CARS organization, focussing on workflow analysis tools and the digital operating room. Eleven specific presentations of the Arrowhead Seminar have been summarized in this review referring to redesigning perioperative care for a high velocity OR, intraoperative ultrasound process and model, surgical workflow and surgical PACS, an integrated view , interactions in the surgical OR, workflow automation strategies and target applications, visualisation solutions for the operating room, navigating the fifth dimension, and design of digital operating rooms and interventional suites
The National Library of Medicine is currently funding the Pilot Connections project to promote and support use of the INTERNET in community health care settings. With previous networking applications of this kind largely confined to academic and research environments, the health librarian has emerged as the agent with the unique knowledge and skills to participate in and manage organizational change. An experiment in applied informatics, the Pilot Connections project shows how health librarians should be aware of the expanding opportunities that exist for them to help their organizations cope more effectively with the external trends and forces currently affecting the role and value of information.
Rajalahti, Elina; Heinonen, Jarmo; Saranto, Kaija
The purpose of this paper is to assess nurse educators' competence development in nursing informatics (NI) and to compare their competence to the NI competence of other healthcare professionals. Electronic health records (EHR) have been in use for many years. However, the adoption of the nursing care plan finally made it possible for nurses in Finland to develop a model for structured documentation with nursing terminology. A total of n = 124 (n = 85 pre-test and n = 39 post-test) participants from Universities of Applied Sciences (UAS), hospitals, hospitals' information management and health centres were surveyed with a e-questionnaire designed to assess the development of their NI competences during the nursing documentation development project. The questionnaire included 145 structured questions and 6 open questions. Data analysis focused on classification and comparison of NI competences through data description and statistical parameters using figures and tables. The basic NI competences of the nurse educators were good at the end of project and the nurse educators had better information literacy and information management competences than other participants. The information retrieval skills varied greatly, but they improved evenly towards the end. The nurse educators mastered better evidence-based nursing and use of nursing process models in their work.
Raybould, Ted P; Wrightson, A Stevens; Massey, Christi Sporl; Smith, Tim A; Skelton, Judith
Childhood oral disease is a significant health problem, particularly for vulnerable populations. Since a major focus of General Dentistry Program directors is the management of vulnerable populations, we wanted to assess their attitudes regarding the inclusion of physicians in the prevention, assessment, and treatment of childhood oral disease. A survey was mailed to all General Practice Residency and Advanced Education in General Dentistry program directors (accessed through the ADA website) to gather data. Spearman's rho was used to determine correlation among variables due to nonnormal distributions. Overall, Advanced General Dentistry directors were supportive of physicians' involvement in basic aspects of oral health care for children, with the exception of applying fluoride varnish. The large majority of directors agreed with physicians' assessing children's oral health and counseling patients on the prevention of dental problems. Directors who treated larger numbers of children from vulnerable populations tended to strongly support physician assistance with early assessment and preventive counseling.
Arunasalam, Mark; Paulson, Albert; Wallace, William
Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers.
Pathman, Donald E.; Morgan, Jennifer Craft; Konrad, Thomas R.; Goldberg, Lynda
Purpose: The landscape of education loan repayment programs for health care professionals has been turbulent in recent years, with doubling of the funding for the National Health Service Corps (NHSC) and cuts in funding for some states' programs. We sought to understand how this turbulence is being felt within the state offices involved in…
Martin, Erika G; Meehan, Terence; Schackman, Bruce R
With the Affordable Care Act set to expand insurance coverage to millions more Americans next year, existing discretionary health programs that receive federal support might find themselves competing for funds as the health reform law is fully implemented. To assess the implications the Affordable Care Act might have for discretionary health programs, we focused on state AIDS Drug Assistance Programs, which provide free medications to low-income HIV patients. We conducted semistructured interviews with program managers from twenty-two states. Many of the managers predicted that their programs will change focus to provide "wrap-around services," such as helping newly insured clients finance out-of-pocket expenses, including copayments, deductibles, and premiums. Although program managers acknowledged that they must adapt to a changing environment, many said that they were overwhelmed by the complexity of the Affordable Care Act, and some expressed fear that state AIDS Drug Assistance Programs would be eliminated entirely. To remain viable, such programs must identify and justify the need for services in the context of the Affordable Care Act and receive sufficient political support and funding.
Cramer, Hendrik; Dewulf, Geert; Voordijk, Hans
This study deals with the governance of a transition program (2007–2011) that tried to radically change a fragmented, supply-driven long-term care system into an integrated, demand-driven system to deal with an aging population. The transition program was subsidized by the healthcare ministry and en
Rachlis, Beth; Sodhi, Sumeet; Burciul, Barry; Orbinski, James; Cheng, Amy H Y; Cole, Donald
Community-based care (CBC) can increase access to key services for people affected by HIV/AIDS through the mobilization of community interests and resources and their integration with formal health structures. Yet, the lack of a systematic framework for analysis of CBC focused on HIV/AIDS impedes our ability to understand and study CBC programs. We sought to develop taxonomy of CBC programs focused on HIV/AIDS in resource-limited settings in an effort to understand their key characteristics, uncover any gaps in programming, and highlight the potential roles they play. Our review aimed to systematically identify key CBC programs focused on HIV/AIDS in resource-limited settings. We used both bibliographic database searches (Medline, CINAHL, and EMBASE) for peer-reviewed literature and internet-based searches for gray literature. Our search terms were 'HIV' or 'AIDS' and 'community-based care' or 'CBC'. Two co-authors developed a descriptive taxonomy through an iterative, inductive process using the retrieved program information. We identified 21 CBC programs useful for developing taxonomy. Extensive variation was observed within each of the nine categories identified: region, vision, characteristics of target populations, program scope, program operations, funding models, human resources, sustainability, and monitoring and evaluation strategies. While additional research may still be needed to identify the conditions that lead to overall program success, our findings can help to inform our understanding of the various aspects of CBC programs and inform potential logic models for CBC programming in the context of HIV/AIDS in resource-limited settings. Importantly, the findings of the present study can be used to develop sustainable HIV/AIDS-service delivery programs in regions with health resource shortages.
Hashimoto, Kiyota; Iwamoto, Hidekazu
This book introduces new trends of theory and practice of information technologies in tourism. The book does not handle only the fundamental contribution, but also discusses innovative and emerging technologies to promote and develop new generation tourism informatics theory and their applications. Some chapters are concerned with data analysis, web technologies, social media, and their case studies. Travel information on the web provided by travelers is very useful for other travelers make their travel plan. A chapter in this book proposes a method for interactive retrieval of information on accommodation facilities to support travelling customers in their travel preparations. Also an adaptive user interface for personalized transportation guidance system is proposed. Another chapter in this book shows a novel support system for the collaborative tourism planning by using the case reports that are collected via Internet. Also, a system for recommending hotels for the users is proposed and evaluated. Other ch...
Huang, H K
Historical reviews of PACS (picture archiving and communication system) and imaging informatics development from different points of view have been published in the past (Huang in Euro J Radiol 78:163-176, 2011; Lemke in Euro J Radiol 78:177-183, 2011; Inamura and Jong in Euro J Radiol 78:184-189, 2011). This retrospective attempts to look at the topic from a different angle by identifying certain basic medical imaging inventions in the 1960s and 1970s which had conceptually defined basic components of PACS guiding its course of development in the 1980s and 1990s, as well as subsequent imaging informatics research in the 2000s. In medical imaging, the emphasis was on the innovations at Georgetown University in Washington, DC, in the 1960s and 1970s. During the 1980s and 1990s, research and training support from US government agencies and public and private medical imaging manufacturers became available for training of young talents in biomedical physics and for developing the key components required for PACS development. In the 2000s, computer hardware and software as well as communication networks advanced by leaps and bounds, opening the door for medical imaging informatics to flourish. Because many key components required for the PACS operation were developed by the UCLA PACS Team and its collaborative partners in the 1980s, this presentation is centered on that aspect. During this period, substantial collaborative research efforts by many individual teams in the US and in Japan were highlighted. Credits are due particularly to the Pattern Recognition Laboratory at Georgetown University, and the computed radiography (CR) development at the Fuji Electric Corp. in collaboration with Stanford University in the 1970s; the Image Processing Laboratory at UCLA in the 1980s-1990s; as well as the early PACS development at the Hokkaido University, Sapporo, Japan, in the late 1970s, and film scanner and digital radiography developed by Konishiroku Photo Ind. Co. Ltd
Rønsen, Astrid; Hanssen, Ingrid
In this article is presented a post-graduate program in palliative care nursing focusing communication. The teaching plan was inspired by action learning, and the students' discovery processes necessitated a variety of teaching methods. The program was based on a holistic view of the human being and of inter-human communication. Neuro-motoric stimulation exercises were used to improve the students' focus of attention, sensory reception, and awareness of their corporeal and intellectual selves. Stimulation of relational skills, the discussion of ethical and difficult questions, and narratives helped students discover relationships between theoretical knowledge and palliative practice, and were used to explain and illustrate topics, and as backgrounds for discussions. During the program the students examined, challenged, and continuously reflected upon their explicit and unconscious praxis theories and their communicative habits. Although very different from educational programs they previously had experienced, this teaching/learning plan and the outcome thereof was positively evaluated. At the end of the year the students found themselves to be more knowledgeable, discerning and self-confident nurses. Even so, some found that they needed more time to digest what they had learned and for new knowledge and philosophies to become internalised.
Full Text Available Abstract Background Hospital in the home programs have been implemented in several countries and have been shown to be safe substitutions (alternatives to in-patient hospitalization. These programs may offer a solution to the increasing demands made on tertiary care facilities and to surge capacity. We investigated the acceptance of this type of care provision with nurse practitioners as the designated principal home care providers in a family medicine program in a large Canadian urban setting. Methods Patients requiring hospitalization to the family medicine service ward, for any diagnosis, who met selection criteria, were invited to enter the hospital in the home program as an alternative to admission. Participants in the hospital in the home program, their caregivers, and the physicians responsible for their care were surveyed about their perceptions of the program. Nurse practitioners, who provided care, were surveyed and interviewed. Results Ten percent (104 of admissions to the ward were screened, and 37 patients participated in 44 home hospital admissions. Twenty nine patient, 17 caregiver and 38 provider surveys were completed. Most patients (88%–100% and caregivers (92%–100% reported high satisfaction levels with various aspects of health service delivery. However, a significant proportion in both groups stated that they would select to be treated in-hospital should the need arise again. This was usually due to fears about the safety of the program. Physicians (98%–100% and nurse practitioners also rated the program highly. The program had virtually no negative impact on the physician workload. However nurse practitioners felt that the program did not utilize their full expertise. Conclusion Provision of hospital level care in the home is well received by patients, their caregivers and health care providers. As a new program, investment in patient education about program safety may be necessary to ensure its long term success. A
Most hospitals are frantically planning recruitment strategies to attract new nurses for intensive care units. The direct cost associated with orientation of one of these nurses is estimated at greater than $2000, plus 6 months' to 1 year's salary per nurse. An interim strategy of using registered nurses to fill a full-time position for 1 year can cost upwards of $75,000 a year. Germane to the acclimatization of these nurses to the intensive care unit is the nurturing role of experienced nurses during the orientation and in assuring continuity of high-quality patient care. By virtue of their position, experienced nurses also model leadership behavior, and they are exposed to many day-to-day stresses that may leave them frustrated and feeling a lack of accomplishment. These factors, coupled with the scarcity of educational opportunities designed specifically for experienced nurses and a perceived absence of challenges, can lead to burnout. In this article I will describe an innovation in practice that uses the clinical nurse specialist role to stimulate and challenge experienced nurses. The program taught, supported, and nurtured unit-based change initiated by experienced nurses.
Davies, Betty; Steele, Rose; Collins, John B; Cook, Karen; Smith, Stephany
With increasing trends towards home care of children with even the most complex conditions and care requirements, respite becomes critical in improving the quality of life for terminally ill children and their families. This article reports on the respite component of an evaluation project that examined the effect of the Canuck Place children's hospice program on the families it served during its first 30 months of operation. Canuck Place, located in Vancouver, British Columbia, Canada, is the first free-standing children's hospice in North America. Findings are derived from mail-out surveys to 144 families, face-to-face interviews with 18 families, and separate questionnaires specifically directed to parents who had used Canuck Place respite services. Sixty-five parents responded to the respite questions. They cited a wide range of benefits to the ill child, the child's siblings, and to the parents themselves; they also offered a few cautions. Our discussion focuses on three "lessons learned" from this unique investigation of respite within pediatric hospice care.
Delfini, Patrícia Santos de Souza; Sato, Miki Takao; Antoneli, Patrícia de Paulo; Guimarães, Paulo Octávio da Silva
The objective of the article is to report an experience of partnership between a Psychosocial Care Center and three teams of the Family Health Program in the central region of São Paulo city. theoretical concepts like territory, subject, subjectivity/collective, receptiveness, bond, co-responsibility as well as the psychiatric and sanitary reform principles are the base and guide of this work. The partnership aims the promotion of mental health care based on articulated actions from different services. This way, the PSF's and mental health's workers are responsible for the demands of a territory. The strategies used in this partnership were meetings with both teams with training, case discussion about the families assisted, support to workers' difficulties and elaboration of therapeutical projects, and joint domiciliary visits. Some difficulties had been found during the research: great demand for health services and lack of institutional guidelines to guarantee the effectiveness of the partnership. The look directed to the family and the social context presents positive results compared to the look directed only to the illness. The partnership enriches the practice and a larger network of care in the territory becomes possible. It is necessary to bring up new proposals and innovative enterprises.
Full Text Available Abstract Background Despite the pressing need for the creation of applications that facilitate the aggregation of clinical and molecular data, most current applications are proprietary and lack the necessary compliance with standards that would allow for cross-institutional data exchange. In line with its mission of accelerating research discoveries and improving patient outcomes by linking networks of researchers, physicians, and patients focused on cancer research, caBIG (cancer Biomedical Informatics Grid™ has sponsored the creation of the caTRIP (Cancer Translational Research Informatics Platform tool, with the purpose of aggregating clinical and molecular data in a repository that is user-friendly, easily accessible, as well as compliant with regulatory requirements of privacy and security. Results caTRIP has been developed as an N-tier architecture, with three primary tiers: domain services, the distributed query engine, and the graphical user interface, primarily making use of the caGrid infrastructure to ensure compatibility with other tools currently developed by caBIG. The application interface was designed so that users can construct queries using either the Simple Interface via drop-down menus or the Advanced Interface for more sophisticated searching strategies to using drag-and-drop. Furthermore, the application addresses the security concerns of authentication, authorization, and delegation, as well as an automated honest broker service for deidentifying data. Conclusion Currently being deployed at Duke University and a few other centers, we expect that caTRIP will make a significant contribution to further the development of translational research through the facilitation of its data exchange and storage processes.
Kaddoura, Mahmoud A
It is essential for nurses to develop critical thinking skills to ensure their ability to provide safe and effective care to patients with complex and variable needs in ever-changing clinical environments. To date, very few studies have been conducted to examine how nursing orientation programs develop the critical thinking skills of novice critical care nurses. Strikingly, no research studies could be found about the American Association of Critical Care Nurses Essentials of Critical Care Orientation (ECCO) program and specifically its effect on the development of nurses' critical thinking skills. This study explored the perceptions of new graduate nurses regarding factors that helped to develop their critical thinking skills throughout their 6-month orientation program in the intensive care unit. A convenient non-probability sample of eight new graduates was selected from a hospital that used the ECCO program. Data were collected with demographic questionnaires and semi-structured interviews. An exploratory qualitative research method with content analysis was used to analyze the data. The study findings showed that new graduate nurses perceived that they developed critical thinking skills that improved throughout the orientation period, although there were some challenges in the ECCO program. This study provides data that could influence the development and implementation of future nursing orientation programs.
M R Rajagopal
Full Text Available Background: It is important to ensure that minimum standards for palliative care based on available resources are clearly defined and achieved. Aims: (1 Creation of minimum National Standards for Palliative Care for India. (2 Development of a tool for self-evaluation of palliative care organizations. (3 Evaluation of the tool in India. In 2006, Pallium India assembled a working group at the national level to develop minimum standards. The standards were to be evaluated by palliative care services in the country. Materials and Methods: The working group prepared a "standards" document, which had two parts - the first composed of eight "essential" components and the second, 22 "desirable" components. The working group sent the document to 86 hospice and palliative care providers nationwide, requesting them to self-evaluate their palliative care services based on the standards document, on a modified Likert scale. Results: Forty-nine (57% palliative care organizations responded, and their self-evaluation of services based on the standards tool was analyzed. The majority of the palliative care providers met most of the standards identified as essential by the working group. A variable percentage of organizations had satisfied the desirable components of the standards. Conclusions: We demonstrated that the "standards tool" could be applied effectively in practice for self-evaluation of quality of palliative care services.
Pettigrew, Melinda M; Forman, Howard P; Pistell, Anne F; Nembhard, Ingrid M
Increasingly, there is recognition of the need for individuals with expertise in both management and public health to help health care organizations deliver high-quality and cost-effective care. The Yale School of Public Health and Yale School of Management began offering an accelerated Master of Business Administration (MBA) and Master of Public Health (MPH) joint degree program in the summer of 2014. This new program enables students to earn MBA and MPH degrees simultaneously from 2 fully accredited schools in 22 months. Students will graduate with the knowledge and skills needed to become innovative leaders of health care organizations. We discuss the rationale for the program, the developmental process, the curriculum, benefits of the program, and potential challenges.
Full Text Available Elissa Burton,1,2 Gill Lewin,1,2 Lindy Clemson,3 Duncan Boldy41Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 2Research Department, Silver Chain, Perth, WA, Australia; 3Health and Work Research Unit, The University of Sydney, Sydney, NSW, Australia; 4School of Nursing and Midwifery, Curtin University, Perth, WA, AustraliaBackground: Restorative home care services are short-term and aimed at maximizing a person’s ability to live independently. They are multidimensional and often include an exercise program to improve strength, mobility, and balance. The aim of this study was to determine whether a lifestyle exercise program would be undertaken more often and result in greater functional gains than the current structured exercise program delivered as part of a restorative home care service for older adults.Methods: A pragmatic randomized controlled trial was conducted in an organization with an established restorative home care service. Individuals who were to have an exercise program as part of their service were randomized to receive either a lifestyle and functional exercise program called LiFE (as this was a new program, the intervention or the structured exercise program currently being used in the service (control. Exercise data collected by the individuals throughout and pre and post intervention testing was used to measure balance, strength, mobility, falls efficacy, vitality, function, and disability.Results: There was no difference between the groups in the amounts of exercise undertaken during the 8-week intervention period. Outcome measurement indicated that the LiFE program was as effective, and on 40% of the measures, more effective, than the structured exercise program.Conclusion: Organizations delivering restorative home care services that include an exercise component should consider whether LiFE rather than the exercise program they are currently using could help their clients achieve better outcomes
Full Text Available Abstract Background In 2001, the Instituto Mexicano del Seguro Social (IMSS carried out a major reorganization to provide comprehensive preventive care to reinforce primary care services through the PREVENIMSS program. This program divides the population into programmatic age groups that receive specific preventive services: children (0-9 years, adolescents (10-19 years, men (20-59 years, women (20-59 years and older adults (> = 60 years. The objective of this paper is to describe the improvement of the PREVENIMSS program in terms of the increase of coverage of preventive actions and the identification of unmet needs of unsolved and emergent health problems. Methods From 2003 to 2006, four nation-wide cross-sectional probabilistic population based surveys were conducted using a four stage sampling design. Thirty thousand households were visited in each survey. The number of IMSS members interviewed ranged from 79,797 respondents in 2003 to 117,036 respondents in 2006. Results The four surveys showed a substantial increase in coverage indicators for each age group: children, completed schemes of vaccination (> 90%, iron supplementation (17.8% to 65.5%, newborn screening for metabolic disorders (60.3% to 81.6%. Adolescents, measles - rubella vaccine (52.4% to 71.4%, hepatitis vaccine (9.3% to 46.2%, use of condoms (17.9% to 59.9%. Women, measles-rubella vaccine (28.5% to 59-2%, cervical cancer screening (66.7% to 75%, breast cancer screening (> 2.1%. Men, type 2 diabetes screening (38.6% to 57.8% hypertension screening (48-4% to 64.0%. Older adults, pneumococcal vaccine (13.2% to 24.9%, influenza vaccine (12.6% to 52.9 Regarding the unmet needs, the prevalence of anemia in children was 30% and a growing prevalence of overweight and obesity, type 2 diabetes, and hypertension was found in men, women and older adults. Conclusion PREVENIMSS showed an important increase in the coverage of preventive services and stressed the magnitude of the old and
Maney, George A
End-user informatics applications are Internet data web management automation solutions. These are mass modeling and mass management collaborative communal consensus solutions. They are made and maintained by managerial, professional, technical and specialist end-users. In end-user informatics the end-users are always right. So it becomes necessary for information technology professionals to understand information and informatics from the end-user perspective. End-user informatics starts with the observation that practical prose is a mass consensus communal modeling technology. This high technology is the mechanistic modeling medium we all use every day in all of our practical pursuits. Practical information flows are the lifeblood of modern capitalist communities. But what exactly is practical information? It's ultimately physical information, but the physics is highly emergent rather than elementary. So practical reality is just physical reality in deep disguise. Practical prose is the medium that we all us...
Monteleoni, Claire; Schmidt, Gavin A.; McQuade, Scott
The goal of climate informatics, an emerging discipline, is to inspire collaboration between climate scientists and data scientists, in order to develop tools to analyze complex and ever-growing amounts of observed and simulated climate data, and thereby bridge the gap between data and understanding. Here, recent climate informatics work is presented, along with details of some of the field's remaining challenges. Given the impact of climate change, understanding the climate system is an international priority. The goal of climate informatics is to inspire collaboration between climate scientists and data scientists, in order to develop tools to analyze complex and ever-growing amounts of observed and simulated climate data, and thereby bridge the gap between data and understanding. Here, recent climate informatics work is presented, along with details of some of the remaining challenges.
Andreopoulou, Z.; Manos, B.; Polman, N.B.P.; Viaggi, D.
Agricultural and Environmental Informatics, Governance and Management: Emerging Research Applications is a state-of-the-art reference book which explores how rural policymakers and stakeholders can use information and communication technologies to sustainably manage agricultural and natural resource
Mohapatra, Durga; Konar, Amit; Chakraborty, Aruna
Advanced Computing, Networking and Informatics are three distinct and mutually exclusive disciplines of knowledge with no apparent sharing/overlap among them. However, their convergence is observed in many real world applications, including cyber-security, internet banking, healthcare, sensor networks, cognitive radio, pervasive computing amidst many others. This two-volume proceedings explore the combined use of Advanced Computing and Informatics in the next generation wireless networks and security, signal and image processing, ontology and human-computer interfaces (HCI). The two volumes together include 148 scholarly papers, which have been accepted for presentation from over 640 submissions in the second International Conference on Advanced Computing, Networking and Informatics, 2014, held in Kolkata, India during June 24-26, 2014. The first volume includes innovative computing techniques and relevant research results in informatics with selective applications in pattern recognition, signal/image process...
Ma, Xiaoyan; Han, Zhongdong; Ma, Hua
This article aims at clarifying the strategic significance of developing medical informatics, conducting SWOT analysis on this discipline and hence establishing the strategic objectives and focal points for its development.
Full Text Available The paper contains issues regarding: main characteristics and examples of the distributed informatics systems and main difference categories among them, concepts, principles, techniques and fields for auditing the distributed informatics systems, concepts and classes of the standard term, characteristics of this one, examples of standards, guidelines, procedures and controls for auditing the distributed informatics systems. The distributed informatics systems are characterized by the following issues: development process, resources, implemented functionalities, architectures, system classes, particularities. The audit framework has two sides: the audit process and auditors. The audit process must be led in accordance with the standard specifications in the IT&C field. The auditors must meet the ethical principles and they must have a high-level of professional skills and competence in IT&C field.
9th Early Detection Research Network (EDRN) Scientific Workshop. Excellence in Computational Biology and Informatics: Sponsored by the EDRN Data Sharing Subcommittee Moderator: Daniel Crichton, M.S., NASA Jet Propulsion Laboratory
The health informatics profession in Bosnia and Herzegovina has relatively long history. Thirty five years from the introduction of the first automatic manipulation of data, thirty years from the establishment of Society for Medical Informatics BiH, twenty years from the establishment of the Scientific journal "Acta Informatica Medica (Acta Inform Med", indexed in PubMed, PubMed Central Scopus, Embase, etc.), twenty years on from the establishment of the first Cathedra for Medical Informatics on Biomedical Faculties in Bosnia and Herzegovina, ten years on from the introduction of the method of "Distance learning" in medical curriculum. The author of this article is eager to mark the importance of the above mentioned Anniversaries in the development of Health informatics in Bosnia and Herzegovina and have attempted, very briefly, to present the most significant events and persons with essential roles throughout this period.
Van Royen Paul
Full Text Available Abstract Background Most research publications on Chronic Care Model (CCM implementation originate from organizations or countries with a well-structured primary health care system. Information about efforts made in countries with a less well-organized primary health care system is scarce. In 2003, the Belgian National Institute for Health and Disability Insurance commissioned a pilot study to explore how care for type 2 diabetes patients could be organized in a more efficient way in the Belgian healthcare setting, a setting where the organisational framework for chronic care is mainly hospital-centered. Methods Process evaluation of an action research project (2003–2007 guided by the CCM in a well-defined geographical area with 76,826 inhabitants and an estimated number of 2,300 type 2 diabetes patients. In consultation with the region a program for type 2 diabetes patients was developed. The degree of implementation of the CCM in the region was assessed using the Assessment of Chronic Illness Care survey (ACIC. A multimethod approach was used to evaluate the implementation process. The resulting data were triangulated in order to identify the main facilitators and barriers encountered during the implementation process. Results The overall ACIC score improved from 1.45 (limited support at the start of the study to 5.5 (basic support at the end of the study. The establishment of a local steering group and the appointment of a program manager were crucial steps in strengthening primary care. The willingness of a group of well-trained and motivated care providers to invest in quality improvement was an important facilitator. Important barriers were the complexity of the intervention, the lack of quality data, inadequate information technology support, the lack of commitment procedures and the uncertainty about sustainable funding. Conclusion Guided by the CCM, this study highlights the opportunities and the bottlenecks for adapting chronic care
Gerritsen, D.L.; Smalbrugge, M.; Teerenstra, S.; Leontjevas, R.; Adang, E.M.M.; Vernooij-Dassen, M.J.F.J.; Derksen, E.; Koopmans, R.T.C.M.
BACKGROUND: The aim of this study is evaluating the (cost-) effectiveness of a multidisciplinary, evidence based care program to improve the management of depression in nursing home residents of somatic and dementia special care units. The care program is an evidence based standardization of the man
Phillips, M [University Washington, Seattle, WA (United States); Kalet, I [Kirkland, WA (United States); McNutt, T [Johns Hopkins University, Severna Park, MD (United States); Smith, W [New York Oncology Hematology, Albany, NY (United States)
Biomedical informatics encompasses a very large domain of knowledge and applications. This broad and loosely defined field can make it difficult to navigate. Physicists often are called upon to provide informatics services and/or to take part in projects involving principles of the field. The purpose of the presentations in this symposium is to help medical physicists gain some knowledge about the breadth of the field and how, in the current clinical and research environment, they can participate and contribute. Three talks have been designed to give an overview from the perspective of physicists and to provide a more in-depth discussion in two areas. One of the primary purposes, and the main subject of the first talk, is to help physicists achieve a perspective about the range of the topics and concepts that fall under the heading of 'informatics'. The approach is to de-mystify topics and jargon and to help physicists find resources in the field should they need them. The other talks explore two areas of biomedical informatics in more depth. The goal is to highlight two domains of intense current interest--databases and models--in enough depth into current approaches so that an adequate background for independent inquiry is achieved. These two areas will serve as good examples of how physicists, using informatics principles, can contribute to oncology practice and research. Learning Objectives: To understand how the principles of biomedical informatics are used by medical physicists. To put the relevant informatics concepts in perspective with regard to biomedicine in general. To use clinical database design as an example of biomedical informatics. To provide a solid background into the problems and issues of the design and use of data and databases in radiation oncology. To use modeling in the service of decision support systems as an example of modeling methods and data use. To provide a background into how uncertainty in our data and knowledge can be
Based on the status quo of rural informatization and information service,this article conducts analysis and discussion of problems in rural informatization and urban-rural information fusion,using statistics. And corresponding countermeasures are put forward as follows: building rural information platform; strengthening information literacy training in rural areas and cultivating new farmers; making information network serve production and operation to increase jobs and income for farmers; developing rural e-commerce; enhancing network information security and prevention.
Cuttone, Andrea; Petersen, Michael Kai; Larsen, Jakob Eg
In this paper we discuss how to facilitate the process of reflection in Personal Informatics and Quantified Self systems through interactive data visualizations. Four heuristics for the design and evaluation of such systems have been identified through analysis of self-tracking devices and apps...... in financial analytics, it is discussed how the heuristics could guide designs that would further facilitate reflection in self-tracking personal informatics systems....
Ferris, Kim; Jones, Dumont; Schultz, Brian
Inorganic semiconducting materials used in gamma radiation detection applications are typically binary and ternary inorganic crystals. Performance metrics for these materials include band gap, relating to carrier concentration and thermal background current; density, relating to stopping power; and electron mobility, which limits electron transport and is typically the dominant information carrier. In this paper, we describe an information-based approach to the identification of new radiation detection materials, using the specific case of the II-VI semiconductors. Even for simple binary systems, the sheer number of potential materials considering the presence of crystal system polymorphs and higher order compositions is daunting. The key to a successful materials search is the ability to suggest promising materials and a priori eliminate unfruitful inquiry. The success of an informatics-based design program depends on the relation of materials-level properties to atomic-scale properties that change rationally with structure, and the ability to extract rules which define these mappings. A brief example of a property-level screen will be given to illustrate the materials development process. The authors gratefully acknowledge financial support from U.S. Department of Homeland Security under Contract No. HSHQDC-08-X-00872.
Sakamoto, Ryota; Miura, Yasushi
[Purpose] This study investigated the long-term effect of a half-day exercise intervention program on health-related quality of life, life function, and physical function in frail elderly in need of care. The program was conducted at a senior day-care facility specializing in functional training. [Subjects and Methods] Subjects included 41 elderly in need of care who had visited the service facility for at least 1 year. Physical function and life function were evaluated at baseline, 6 months, and 12 months. Quality of life was evaluated with the Short Form-36 at baseline and 12 months. [Results] Improvements in balance, walking speed and endurance, complex performance abilities, self-efficacy during the activities, and the level and sphere of activity were observed at 6 months and maintained up to 12 months. Moreover, improvements in agility, activities of daily living, life function, and quality of life were also observed at 12 months. Improvements in muscle strength, walking ability, self-efficacy over an action, and activities of daily living were related to the improvement in quality of life. [Conclusion] The use of individualized exercise programs developed by physiotherapists led to improvements in activities of daily living and quality of life among elderly in need of care. PMID:27512243
Bulduk, Serap; Usta, Esra; Dinçer, Yeliz
Spiritual care means helping an individual protect, maintain and gain all the dimensions of his/her existence. Elderly care technicians face numerous cases or crisis situations in which elderly individuals from different backgrounds question the meaning and value of life. Elderly care technicians must acknowledge that the spirituality is an important element in the way an elderly individual receives healthcare and they must be equipped for this matter. This study was conducted in order to examine the influence of "Skill Development Training Program for Spiritual Care of Elderly Individual," which was carried out with students from elderly care program, on the perception of spirituality support in a pretest-posttest quasi-experimental study design with control group. As the data collection form, "Spiritual Support Perception" (SSP) scale was used. The mean scores of the intervention group after the training and after one month are 50.39 ± 5.34 and 51.13 ± 4.98, respectively, and those of the control group are 43.16 ± 4.83 and 42.72 ± 4.48. A statistically significant difference was found between the mean scores of the intervention group from the pretest and the posttests immediately after the training and one month after the training (f = 94.247, p = 0.001). In the control group, however, there was no significant change in the SSP mean scores (f = 0.269, p = 0.77). As a result, this study pointed out the necessity of such training programs for healthcare professionals to make a distinction between their professional duties and their own personalities in order to offer spiritual care to the elderly individual.
Hospice care is end-of-life care. A team of health care professionals and volunteers provides it. ... can remain as alert and comfortable as possible. Hospice programs also provide services to support a patient's ...
Nishikawa, Mitsunori; Miura, Hisayuki; Oya, Sanae; Kato, Tomonari; Nagae, Hiroyuki; Osada, Yoshiyuki; Watanabe, Tetsuya; Matsuoka, Sachiko; Otsuka, Yasuro; Yamaguchi, Mie; Watanabe, Kazuko; Kito, Katsutoshi; Ooi, Hatsue; Suzuki, Naoko
Promoting advance care planning in regional areas is important. Education For Implementing End-of-Life Discussion(EFIELD) is a two-day educational program for Advance Care Planning Facilitators(ACPFs)developed by the National Center for Geriatrics and Gerontology. Unfortunately, some trainers experience difficulties implementing the content of the program, and some trainees feel the program is too long for implementation in many regional areas. The purpose of the research is to clarify the feasibility of ACPFs education using a one-day program in regional areas. The methods involved documenting the process of a one-day program from implementation to evaluation from May of 2015 to March of 2016 and then evaluating the effectiveness of the program 3 months after the implementation using meeting minutes from 7 local hospitals. The results indicated a need for 5 steps from program implementation to evaluation as well as 5 categories for final evaluation. The most important finding is that E-FIELD challenged trainers to shorten and simplify their expressions in order to teach the content more efficiently. The second finding is that Group for Promoting Advance Care Planning & End Of Life Discussion in Chita(GACPEL) activities encouraged ACPimplementation within each hospital. The limitations of this research are related to small regional areas. In conclusion, a one-day regional ACPFs educational program is feasible.
Chan, Juliana C N; Ozaki, Risa; Luk, Andrea; Kong, Alice P S; Ma, Ronald C W; Chow, Francis C C; Wong, Patrick; Wong, Rebecca; Chung, Harriet; Chiu, Cherry; Wolthers, Troels; Tong, Peter C Y; Ko, Gary T C; So, Wing-Yee; Lyubomirsky, Greg
Diabetes is a global epidemic, and many affected individuals are undiagnosed, untreated, or uncontrolled. The silent and multi-system nature of diabetes and its complications, with complex care protocols, are often associated with omission of periodic assessments, clinical inertia, poor treatment compliance, and care fragmentation. These barriers at the system, patient, and care-provider levels have resulted in poor control of risk factors and under-usage of potentially life-saving medications such as statins and renin-angiotensin system inhibitors. However, in the clinical trial setting, use of nurses and protocol with frequent contact and regular monitoring have resulted in marked differences in event rates compared to epidemiological data collected in the real-world setting. The phenotypic heterogeneity and cognitive-psychological-behavioral needs of people with diabetes call for regular risk stratification to personalize care. Quality improvement initiatives targeted at patient education, task delegation, case management, and self-care promotion had the largest effect size in improving cardio-metabolic risk factors. The Joint Asia Diabetes Evaluation (JADE) program is an innovative care prototype that advocates a change in clinic setting and workflow, coordinated by a doctor-nurse team and augmented by a web-based portal, which incorporates care protocols and a validated risk engine to provide decision support and regular feedback. By using logistics and information technology, supported by a network of health-care professionals to provide integrated, holistic, and evidence-based care, the JADE Program aims to establish a high-quality regional diabetes database to reflect the status of diabetes care in real-world practice, confirm efficacy data, and identify unmet needs. Through collaborative efforts, we shall evaluate the feasibility, acceptability, and cost-effectiveness of this "high tech, soft touch" model to make diabetes and chronic disease care more
Full Text Available Rawda KhouriAl Hussein Bin Talal University, Princess Aisha Bint Al Hussein College Of Nursing, Ma’an, JordanBackground: Framing and development of clinical skills in nursing students during their clinical practice is critical because this can shape their future caring skills. Professional caring empowers patients and contributes to their well-being and health. Education may enhance the capacity of nurses to be effective caring practitioners. Their study program encourages caring behavior in nursing students, consequently affecting their professional self-perception.Methods: The present study investigated the effect of an educational program on caring behavior and professional self-perception in nursing students using a controlled pre/post test study design. The study sample consisted of 50 nursing students undertaking their final year in 2010–2011. Subjects were randomly assigned to either an experimental or a control group. The study was conducted in two critical care units affiliated to the Ma’an and Queen Rania hospitals in the south of Jordan. The instruments utilized were the Caring Dimensions Inventory, Nursing Students Attitude Observational Checklist, and Professional Self-Concept of Nurses Instrument.Results: The study findings favor the effect of the educational program because there was increased knowledge and understanding of caring theory and related concepts, a more holistic approach to care, enhanced caring practices, and improved self-perception in the study group compared with the control group during different periods of assessment. The study group showed significantly better caring perception in psychological, technical, and professional terms than the control group during different periods of assessment. There was a significant positive trend of overall professional self-perception for the study group compared with the control group.Conclusion: Nursing curricula should incorporate concepts and principles that guide
Full Text Available Abstract Background Although maintenance care appears to be relatively commonly used among chiropractors, the indications for its use are incompletely understood. A questionnaire survey was recently carried out among Swedish chiropractors in order to identify their choice of various management strategies, including maintenance care. That study revealed a common pattern of choice of strategies. However, it would be necessary to verify these findings in another study population and to obtain some additional information best collected through an interview. Objectives The main aim of the present study was to attempt to reproduce the findings in the Swedish study and to obtain more information on the use of maintenance care. Method A group of 11 chiropractors were selected because they used maintenance care. They were interviewed using the questionnaire from the previous Swedish survey. The questionnaire consisted of a simple description of a hypothetical patient with low back pain and nine possible ways in which the case could develop ("scenarios". They could choose between six different management strategies for each scenario. In addition, the chiropractors were encouraged to provide their own definition of maintenance care in an open-ended question. Interviews were taped, transcribed and analyzed. For the open-ended question, statements were identified relating to six pre hoc defined topics on the inclusion criteria/rationale for maintenance care, the frequency of treatments, and the duration of the maintenance care program. Results The open-ended question revealed that in patients with low back pain, maintenance care appears to be offered to prevent new events. The rationale was to obtain optimal spinal function. There appears to be no common convention on the frequency of treatments and duration of the treatment program was not mentioned by any of the interviewees. Conclusion The results from the questionnaire in the Danish survey showed that
An, Selena J; George, Asha S; LeFevre, Amnesty; Mpembeni, Rose; Mosha, Idda; Mohan, Diwakar; Yang, Ann; Chebet, Joy; Winch, Peter; Abdullah H. Baqui; Kilewo, Charles
Background Women and children in sub-Saharan Africa bear a disproportionate burden of HIV/AIDS. Integration of HIV with maternal and child services aims to reduce the impact of HIV/AIDS. To assess the potential gains and risks of such integration, this paper considers pregnant women’s and providers’ perceptions about the effects of integrated HIV testing and counselling on care seeking by pregnant women during antenatal care in Tanzania. Methods From a larger evaluation of an integrated mater...
Felipe, Gilvan Ferreira; de Abreu, Rita Neuma Dantas Cavalcante; Moreira, Thereza Maria Magalhães
The objective was to observe the aspects of nursing appointments undergone by hypertensive patients. This is a descriptive study, developed in three healthcare centers in the city of Fortaleza. The subjects were 13 nurses, and data collection comprised the observation of three of each nurse's appointments, followed by an interview with this professional. It was observed that, during the anamnesis, the previous treatment, the ingestion of hypertensive substances and the existence of associated risk factors were identified. Inspections of the patient's appearance, blood pressure and weight were also evident. The identified categories were: aspects of the nurse's role in basic healthtcare; treatment of hypertension and day-to-day difficulties of people with this disease. We conclude that many aspects are not being approached during the nursing appointments, which can result in a low-quality healthcare service provided for people cared for the hypertension program in these basic healthcare centers.
Phan, Sieu; Famili, Fazel; Liu, Ziying; Peña-Castillo, Lourdes
The advancement of omics technologies in concert with the enabling information technology development has accelerated biological research to a new realm in a blazing speed and sophistication. The limited single gene assay to the high throughput microarray assay and the laborious manual count of base-pairs to the robotic assisted machinery in genome sequencing are two examples to name. Yet even more sophisticated, the recent development in literature mining and artificial intelligence has allowed researchers to construct complex gene networks unraveling many formidable biological puzzles. To harness these emerging technologies to their full potential to medical applications, the Bio-intelligence program at the Institute for Information Technology, National Research Council Canada, aims to develop and exploit artificial intelligence and bioinformatics technologies to facilitate the development of intelligent decision support tools and systems to improve patient care - for early detection, accurate diagnosis/prognosis of disease, and better personalized therapeutic management.
Pitkajarvi, Marianne; Eriksson, Elina; Kekki, Pertti
The purpose of this study was to research teachers' experiences of the English-Language-Taught Degree Programs in the health care sector of Finnish polytechnics. More specifically, the focus was on teachers' experiences of teaching methods and clinical practice. The data were collected from eighteen teachers in six polytechnics through focus group interviews. Content analysis was used to analyse the data. The results suggested that despite the positive interaction between students and teachers, choosing appropriate teaching methods provided a challenge for teachers, due to cultural diversity of students as well as to the use of a foreign language in tuition. Due to students' language-related difficulties, clinical practice was found to be the biggest challenge in the educational process. Staffs' attitudes were perceived to be significant for students' clinical experience. Further research using stronger designs is needed.
Temboury Molina, M C; Sacristán Martín, A; San Frutos Fernández, M A; Rodríguez Alfaro, F; Llorente González, R
The high prevalence of childhood obesity in our society, its adverse consequences in the psychosocial development of the child, together with its risk of persistence into adulthood, prompted us to carry out this treatment program in our Primary Care Unit. It is based fundamentally on four aspects: diet, physical exercise, psychological and family support. Thirty children, between 4 and 14 years of age, were controlled for 11 months. These children's personal and family characteristics, their habits and psychological aspects were described. An average reduction of the IMC of 2.50 was obtained. The best results were obtained in children with two or more siblings, with a good adherence to the diet and with adequate family support. Sex, obesity of other family members, initial age, previous habits, etc., were not found to be influential. The importance of prevention and family collaboration is emphasized.
Sittig, Dean F; Hazlehurst, Brian L; Brown, Jeffrey; Murphy, Shawn; Rosenman, Marc; Tarczy-Hornoch, Peter; Wilcox, Adam B
Comparative effectiveness research (CER) has the potential to transform the current health care delivery system by identifying the most effective medical and surgical treatments, diagnostic tests, disease prevention methods, and ways to deliver care for specific clinical conditions. To be successful, such research requires the identification, capture, aggregation, integration, and analysis of disparate data sources held by different institutions with diverse representations of the relevant clinical events. In an effort to address these diverse demands, there have been multiple new designs and implementations of informatics platforms that provide access to electronic clinical data and the governance infrastructure required for interinstitutional CER. The goal of this manuscript is to help investigators understand why these informatics platforms are required and to compare and contrast 6 large-scale, recently funded, CER-focused informatics platform development efforts. We utilized an 8-dimension, sociotechnical model of health information technology to help guide our work. We identified 6 generic steps that are necessary in any distributed, multi-institutional CER project: data identification, extraction, modeling, aggregation, analysis, and dissemination. We expect that over the next several years these projects will provide answers to many important, and heretofore unanswerable, clinical research questions.
Shah, Gulzar H.
Background: Electronic health records (EHRs) are evolving the scope of operations, practices, and outcomes of population health in the United States. Local health departments (LHDs) need adequate health informatics capacities to handle the quantity and quality of population health data. Purpose: The purpose of this study was to gain an updated view using the most recent data to identify the primary storage of clinical data, status of data for meaningful use, and characteristics associated with the implementation of EHRs in LHDs. Methods: Data were drawn from the 2015 Informatics Capacity and Needs Assessment Survey, which used a stratified random sampling design of LHD populations. Oversampling of larger LHDs was conducted and sampling weights were applied. Data were analyzed using descriptive statistics and logistic regression in SPSS. Results: Forty-two percent of LHDs indicated the use of an EHR system compared with 58% that use a non-EHR system for the storage of primary health data. Seventy-one percent of LHDs had reviewed some or all of the current systems to determine whether they needed to be improved or replaced, whereas only 6% formally conducted a readiness assessment for health information exchange. Twenty-seven percent of the LHDs had conducted informatics training within the past 12 months. LHD characteristics statistically associated with having an EHR system were having state or centralized governance, not having created a strategic plan related to informatics within the past 2 years throughout LHDs, provided informatics training in the past 12 months, and various levels of control over decisions regarding hardware allocation or acquisition, software selection, software support, and information technology budget allocation. Conclusion: A focus on EHR implementation in public health is pertinent to examining the impact of public health programming and interventions for the positive change in population health. PMID:27684614
Freudenberg, W; Ohya, M
The purpose of this volume is examine bio-informatics and quantum information, which are growing rapidly at present, and to attempt to connect the two, with a view to enumerating and solving the many fundamental problems they entail. To this end, we look for interdisciplinary bridges in mathematics, physics, and information and life sciences. In particular, research into a new paradigm for information science and life science on the basis of quantum theory is emphasized. Sample Chapter(s). Markov Fields on Graphs (599 KB). Contents: Markov Fields on Graphs (L Accardi & H Ohno); Some Aspects of
Oba, Nongnut; McCaffrey, Ruth; Choonhapran, Paungphen; Chutug, Pensri; Rueangram, Sujin
The purpose of this study was to create and test a prevention model for diabetes mellitus in a primary care unit in Thailand. This study used a three-stage approach: a situational analysis was conducted by a focus group discussion, a model was developed in a brainstorming session with stakeholders, and the model was tested by community participation. Qualitative and quantitative methods were used to collect and analyze the data. The focus group discussion found that co-operation between health volunteers and primary care unit personnel in relation to diabetes screening, as well as defining the role of nurse practitioners who provide diabetic treatment, was important. The proactive model that was used for preventing diabetes mellitus was a health promotion program. It was trialed with 160 persons with prediabetes for 3 months. After the intervention, the mean score for exercise activity among the persons with prediabetes was significantly higher, while the mean score of the Body Mass Index, waist circumference, and systolic blood pressure were significantly lower than before the intervention. This meant that community participation provided proactive services to Thai persons with prediabetes.
Dondi, Maurizio; Kashyap, Ravi; Pascual, Thomas; Paez, Diana; Nunez-Miller, Rodolfo
The International Atomic Energy Agency promotes the practice of nuclear medicine among its Member States with a focus on quality and safety. It considers quality culture as a part of the educational process and as a tool to reduce heterogeneity in the practice of nuclear medicine, and in turn, patient care. Sensitization about quality is incorporated in all its delivery mechanisms. The Agency has developed a structured peer-review process called quality management (QM) audits in nuclear medicine practices to help nuclear medicine facilities improve their quality through this voluntary comprehensive audit process. The process is multidisciplinary, covering all aspects of nuclear medicine practice with a focus on the patient. It complements other QM and accreditation approaches developed by professional societies or accreditation agencies. The Agency is committed to propagate its utility and assist in the implementation process. Similar auditing programs for practice in diagnostic radiology and radiotherapy, called QUADRIL and QUATRO, respectively, are also in place. Necessary amendments in the auditing process and content are incorporated based on technological and practice changes with time. The reader will become familiar with the approach of the Agency on QM in nuclear medicine and its implementation process to improve patient care.
Bagger, Bettan; Poulsen, Dorthe Varning; Hørdam, Britta
- Uncover possibilities and barriers in users perspective - Political and cultural visions in European countries Involving the target group - Testing platform and informatics - Moviemaking - Developing learning programs in collaboration with patient organizations Presentation and sharing: - Targetgroup......Political and cultural visions for health care necessitate the need for transnational resources and services optimizing and supporting patients and their families. The project has its approach in an Interregional Project named Pro-hip. Lead partner is University College Zealand collaborating...... borders - Developing new health technology information to hip surgery patients and their relatives - Innovating an interactive media directed to the target group (ex. age and competencies) Methodology: Identifying the field - Literature study - Interviews for identifying needs for the target groups...
Full Text Available Community-based care (CBC can increase access to key services for people affected by HIV/AIDS through the mobilization of community interests and resources and their integration with formal health structures. Yet, the lack of a systematic framework for analysis of CBC focused on HIV/AIDS impedes our ability to understand and study CBC programs. We sought to develop taxonomy of CBC programs focused on HIV/AIDS in resource-limited settings in an effort to understand their key characteristics, uncover any gaps in programming, and highlight the potential roles they play. Our review aimed to systematically identify key CBC programs focused on HIV/AIDS in resource-limited settings. We used both bibliographic database searches (Medline, CINAHL, and EMBASE for peer-reviewed literature and internet-based searches for gray literature. Our search terms were ‘HIV’ or ‘AIDS’ and ‘community-based care’ or ‘CBC’. Two co-authors developed a descriptive taxonomy through an iterative, inductive process using the retrieved program information. We identified 21 CBC programs useful for developing taxonomy. Extensive variation was observed within each of the nine categories identified: region, vision, characteristics of target populations, program scope, program operations, funding models, human resources, sustainability, and monitoring and evaluation strategies. While additional research may still be needed to identify the conditions that lead to overall program success, our findings can help to inform our understanding of the various aspects of CBC programs and inform potential logic models for CBC programming in the context of HIV/AIDS in resource-limited settings. Importantly, the findings of the present study can be used to develop sustainable HIV/AIDS-service delivery programs in regions with health resource shortages.
Essary, Alison C; Wade, Nathaniel L
According to the most recent statistics from the National Center for Education Statistics, disparities in enrollment in undergraduate and graduate education are significant and not improving commensurate with the national population. Similarly, only 12% of graduating medical students and 13% of graduating physician assistant students are from underrepresented racial and ethnic groups. Established in 2012 to promote health care transformation at the organization and system levels, the School for the Science of Health Care Delivery is aligned with the university and college missions to create innovative, interdisciplinary curricula that meet the needs of our diverse patient and community populations. Three-year enrollment trends in the program exceed most national benchmarks, particularly among students who identify as Hispanic and American Indian/Alaska Native. The Science of Health Care Delivery program provides students a seamless learning experience that prepares them to be solutions-oriented leaders proficient in the business of health care, change management, innovation, and data-driven decision making. Defined as the study and design of systems, processes, leadership and management used to optimize health care delivery and health for all, the Science of Health Care Delivery will prepare the next generation of creative, diverse, pioneering leaders in health care.
BACKGROUND: Interferon-gamma release assays including the QuantiFERON-TB Gold In-Tube test (QFT-GIT [Cellestis Ltd, Australia]) may be used in place of the tuberculin skin test (TST) in surveillance programs for Mycobacterium tuberculosis infection control. However, data on performance and practicality of the QFT-GIT in such programs for health care workers (HCWs) are limited.OBJECTIVES: To assess the performance, practicality and reversion rate of the QFT-GIT among HCWs at a tertiary health ...
Haendel, Melissa A; Chesler, Elissa J
From early anatomical lesion studies to the molecular and cellular methods of today, a wealth of technologies have provided increasingly sophisticated strategies for identifying and characterizing the biological basis of behaviors. Bioinformatics is a growing discipline that has emerged from the practical needs of modern biology, and the history of systematics and ontology in data integration and scientific knowledge construction. This revolution in biology has resulted in a capability to couple the rich molecular, anatomical, and psychological assays with advances in data dissemination and integration. However, behavioral science poses unique challenges for biology and medicine, and many unique resources have been developed to take advantage of the strategies and technologies of an informatics approach. The collective developments of this diverse and interdisciplinary field span the fundamentals of database development and data integration, ontology development, text mining, genetics, genomics, high-throughput analytics, image analysis and archiving, and numerous others. For the behavioral sciences, this provides a fundamental shift in our ability to associate and dissociate behavioral processes and relate biological and behavioral entities, thereby pinpointing the biological basis of behavior.
Sopirala, Madhuri M.; Yahle-Dunbar, Lisa; Smyer, Justin; Wellington, Linda; Dickman, Jeanne; Zikri, Nancy; Martin, Jennifer; Kulich, Pat; Taylor, David; Mekhjian, Hagop; Nash, Mary; Mansfield, Jerry; Pancholi, Preeti; Howard, Mary; Chase, Linda; Brown, Susan; Kipp, Kristopher; Lefeld, Kristen; Myers, Amber; Pan, Xueliang; Mangino, Julie E.
Background We describe a successful interdisciplinary liaison program that effectively reduced health care-acquired (HCA), methicillin-resistant Staphylococcus aureus (MRSA) in a university hospital setting. Methods Baseline was from January 2006 to March 2008, and intervention period was April 2008 to September 2009. Staff nurses were trained to be liaisons (link nurses) to infection prevention (IP) personnel with clearly defined goals assigned and with ongoing monthly education. HCA-MRSA incidence per 1,000 patient-days (PD) was compared between baseline and intervention period along with total and non-HCA-MRSA, HCA and non-HCA-MRSA bacteremia, and hand soap/sanitizer usage. Hand hygiene compliance was assessed. Results A reduction in MRSA rates was as follows in intervention period compared with baseline: HCA-MRSA decreased by 28% from 0.92 to 0.67 cases per 1,000 PD (incidence rate ratio, 0.72; 95% confidence interval: 0.62–0.83, P Hand soap/sanitizer usage and compliance with hand hygiene also increased significantly during IP. Conclusion Link nurse program effectively reduced HCA-MRSA. Goal-defined metrics with ongoing reeducation for the nurses by IP personnel helped drive these results. PMID:24548456
Leboeuf-Yde Charlotte; Bjørnstad Charlotte; Sandnes Kjerstin F; Hestbaek Lise
Abstract Background The management of chiropractic patients with acute and chronic/persistent conditions probably differs. However, little is known on this subject. There is, for example, a dearth of information on maintenance care (MC). Thus it is not known if patients on MC are coerced to partake in a program of frequent treatments over a long period of time, or if they are actively involved in designing their own individualized treatment program. Objectives It was the purpose of this study...
Starting from the physical foundations all mathematics required for the quantum informatics are introduced and explained. The essential aspects of the quantum informatics are mathematically formulated. All statements made are also proved in the book.
McNairy, Margaret L.; Lamb, Matthew R.; Abrams, Elaine J.; Elul, Batya; Sahabo, Ruben; Hawken, Mark P.; Mussa, Antonio; Zwede, Ayele; Justman, Jessica; El-Sadr, Wafaa M.
Background The traditional HIV treatment cascade has been noted to have limitations. A proposed comprehensive HIV care cascade that uses cohort methodology offers additional information as it accounts for all patients. Using data from 4 countries, we compare patient outcomes using both approaches. Methods Data from 390,603 HIV-infected adults (>15 years) enrolled at 217 facilities in Kenya, Mozambique, Rwanda, and Tanzania from 2005 to 2011 were included. Outcomes of all patients at 3, 6, and 12 months after enrollment were categorized as optimal, suboptimal, or poor. Optimal outcomes included retention in care, antiretroviral therapy (ART) initiation, and documented transfer. Suboptimal outcomes included retention in care without ART initiation among eligible patients or those without eligibility data. Poor outcomes included loss to follow-up and death. Results The comprehensive HIV care cascade demonstrated that at 3, 6 and 12 months, 58%, 51%, and 49% of patients had optimal outcomes; 22%, 12%, and 7% had suboptimal outcomes, and 20%, 37% and 44% had poor outcomes. Of all patients enrolled in care, 56% were retained in care at 12 months after enrollment. In comparison, the traditional HIV treatment cascade found 89% of patients enrolled in HIV care were assessed for ART eligibility, of whom 48% were determined to be ART-eligible with 70% initiating ART, and 78% of those initiated on ART retained at 12 months. Conclusions The comprehensive HIV care cascade follows outcomes of all patients, including pre-ART patients, who enroll in HIV care over time and uses quality of care parameters for categorizing outcomes. The comprehensive HIV care cascade provides complementary information to that of the traditional HIV treatment cascade and is a valuable tool for monitoring HIV program performance. PMID:26375466
Full Text Available Abstract Background The expectations of patients for managing pain induced by exercise and mobilization (PIEM have seldom been investigated. We identified the views of patients and care providers regarding pain management induced by exercise and mobilization during physical therapy programs. Methods We performed a qualitative study based on semi-structured interviews with a stratified sample of 12 patients (7 women and 14 care providers (6 women: 4 general practitioners [GPs], 1 rheumatologist, 1 physical medicine physician, 1 geriatrician, 2 orthopedic surgeons, and 5 physical therapists. Results Patients and care providers have differing views on PIEM in the overall management of the state of disease. Patients' descriptions of PIEM were polymorphic, and they experienced it as decreased health-related quality of life. The impact of PIEM was complex, and patient views were sometimes ambivalent, ranging from denial of symptoms to discontinuation of therapy. Care providers agreed that PIEM is generally not integrated in management strategies. Care providers more often emphasized the positive and less often the negative dimensions of PIEM than did patients. However, the consequences of PIEM cited included worsened patient clinical condition, fears about physical therapy, rejection of the physical therapist and refusal of care. PIEM follow-up is not optimal and is characterized by poor transmission of information. Patients expected education on how better to prevent stress and anxiety generated by pain, education on mobilization, and adaptations of physical therapy programs according to pain intensity. Conclusion PIEM management could be optimized by alerting care providers to the situation, improving communication among care providers, and providing education to patients and care providers.
Full Text Available Background and Objectives: Since elderlies are susceptible to various impairments due to different physical and mental problems, they need more attention and abiding and efficient self-care program for their health promotion. The present study investigated the effect of self-care training program on quality of life of elderlies. Materials and Methods: This pre- and post-quasi-experimental study was carried out on 160 elderly clients selected from eight health care centers in Zanjan, Iran. The elderlies were selected by randomized sampling and assigned to two groups of experimental (n = 80 and control (n = 80 groups. The experimental group participated in the self-care training program for six sessions of one hour. The study instruments were questionnaires regarding demographic information and short-form health survey (SF-36. Data analysis was performed using SPSS-22 software by independent t-test, Mann-Whitney and chi-squared. Results: The finding showed a significant difference in mean scores of quality of life between the experimental and control groups after the intervention (P < 0.001. Conclusions: Self-care education to elderlies about the practices of proper nutrition, exercise, rest and medication can prevent several problems and help them to improve their quality of lives.
Beich, Jeff; Scanlon, Dennis P; Ulbrecht, Jan; Ford, Eric W; Ibrahim, Ibrahim A
To date, pay-for-performance programs targeting the care of persons with chronic conditions have primarily been directed at physicians and provide an alternative to health plan-sponsored chronic disease management (DM) programs. Both approaches require similar infrastructure, and each has its own advantages and disadvantages for program implementation. Pay-for-performance programs use incentives based on patient outcomes; however, an alternative system might incorporate measures of structure and process. Using a conceptual framework, the authors explore the variation in 50 diabetes DM programs using data from the 2002 National Business Coalition on Health's eValue8 Request for Information (RFI). The authors raise issues relevant to the assignment of accountability for patient outcomes to either health plans or physicians. They analyze the association between RFI scores measuring structures and processes, and HEDIS diabetes intermediate outcome measures. Finally, the strengths and weaknesses of using the RFI scores as an alternative metric for pay-for-performance programs are discussed.