Health Information Technology Commons^™

Increasing Patient Engagement In The African American Community Through Personal Health Record Use, Andrea Perkins

Applied Research Projects

Personal Health records have many potential benefits to patients, caregivers and institutions. In order to meet meaningful use standards EHR systems must allow patients to be able to access and easily download their healthcare records and images for their own use. Previous studies have shown that African Americans are less likely to enroll in a personal health record than other ethnic populations. This study was done to research and identify possible barriers the have limited the utilization of personal health record use in the African American community. A preliminary survey and focus group were convened to discuss issues affecting PHR …

A Single-Parameter Model Of The Immune Response To Bacterial Invasion, Lester Caudill

Math and Computer Science Faculty Publications

The human immune response to bacterial pathogens is a remarkably complex process, involving many different cell types, chemical signals, and extensive lines of communication. Mathematical models of this system have become increasingly high-dimensional and complicated, as researchers seek to capture many of the major dynamics. In this paper, we argue that, in some important instances, preference should be given to low-dimensional models of immune response, as opposed to their high-dimensional counterparts. One such model is analyzed and shown to reflect many of the key phenomenological properties of the immune response in humans. Notably, this model includes a single parameter values, …

Anesthesia Information Management Systems: A Review Of The History, The Products, And The Adoption Of These Systems, Emily G. Hoffner

Applied Research Projects

Anesthesia Information Management Systems (AIMS) have been growing in popularity and use over the past decade, but widespread adoption of these systems by anesthesia groups and hospitals across the country is yet to occur. The promise of AIMS reaches beyond basic anesthesia recordkeeping into a realm of complex, integrated systems with enhanced billing, improved regulatory requirements, improved communication amongst caregivers, and reduced medical-legal exposure. In fact, AIMS have been shown to improve patient care and can increase the financial performance of a group. Despite the documented benefits of AIMS, adoption of these systems is low. This paper will review the …

An Evaluation Of The Role Of The Originator Of Catastrophic Edits/Data Overwrites Within The Veteran Health Administration, Britney Braxton

Applied Research Projects

Objective: To determine which job function causes or creates a large number of Catastrophic Edit/ Data Overwrites within VHA.

Methods: The study is based on data extracted from the Catastrophic Edits Monthly Reports reported by the HC IdM Team staff on the CEs that have occurred on the MPI. Catastrophic Edits (CEs) reported by the HC IdM team between November 2011 through December 2012 are examined.

Result: Out of the 2736 Potential Identity Changes, 115 actually resulted in a CE. The number of CEs created by each job title ranged from 1% by Employee Health Clerk to 28% by Eligibility …

Health Sciences Libraries, Susan Bloomfield, Deborah Clark, Dina Mckelvy, Lucinda White

Maine Policy Review

Health sciences librarians serve as uniquely trained reference librarians who specialize in the research and dissemination of medical and health information and are an important link to quality health information for patients and consumers. The authors describe how the landscape of health sciences librarianship is constantly changing as new technology emerges, along with librarians' roles within the healthcare system.

Analysing A New Mobile Bilateral Audiology Test For Children, Luke J. Brook

Theses : Honours

Hearing loss in Australian children, primarily Aboriginal and Torres Strait Islanders, is a growing concern for the Australian public health sector. In certain rural communities up to 90 per cent of children have been found to experience some form of hearing loss. Although hearing loss can be the result of a number of different causes, including congenital influences, the most common cause of hearing loss in Australian children is attributed to a common middle ear infection, otitis media.

To address the issue, numerous solutions have been proposed, tested and implemented, although the problem persists due to geographic, environmental and cultural …

Information Flow And Clinical Outcomes In A Fully Functional Perinatal Continuum Of Care, Donald Levick Md, Michael Sheinberg Md, Chad D. Meyerhoefer Phd, Mary E. Deily, Shin-Yi Chou Phd, Susan A. Sherer Phd

Administration & Leadership

No abstract provided.

Approaches That Will Yield Greater Success When Implementing Self-Administered Electronic Data Capture Ict Systems In The Developing World With An Illiterate Or Semi-Literate Population, Stanley J. Mierzwa, Samir Souidi, Irene Friedland, Sarah A. Littlefield, Lauren L. Katzen, Craig Savel, Deborah Boccio, Saumya Ramarao

Reproductive Health

The Information Technology (IT) Group at the Population Council responded to a need for a technology solution that would help researchers obtain more accurate responses to survey questions that concerned subject matter of a sensitive nature. The IT Group had three goals: (1) to enhance research by obtaining the best data possible, (2) to operate successfully in the local environment and be welcomed by the local populations, and (3) to increase the efficiency and cost-effectiveness of the survey process. This paper outlines approaches to consider when designing and implementing self-administered information and communications technology (ICT) questionnaires in developing countries, and …

Use Of Health Information Technology For Higher-Value Critical Care, Lena Chen, Edward Kennedy, Anne Sales, Timothy Hofer

Edward H. Kennedy

To illustrate how data from a comprehensive EHR might contribute to better triage decisions, we examined the records of a cohort of 101,912 patients admitted for reasons other than surgery to 121 VA acute care hospitals in fiscal year 2009. Critical care guidelines continue to maintain that the ICU is the place to care for “the most seriously ill patients.” For the most common noncardiac diagnoses, we found that, in keeping with this guideline, patients with a high severity of illness were much more likely to be admitted to the ICU than were patients with a low severity of illness. …

Improved Cardiovascular Risk Prediction Using Nonparametric Regression And Electronic Health Record Data, Edward Kennedy, Wyndy Wiitala, Rodney Hayward, Jeremy Sussman

Edward H. Kennedy

Use of the electronic health record (EHR) is expected to increase rapidly in the near future, yet little research exists on whether analyzing internal EHR data using flexible, adaptive statistical methods could improve clinical risk prediction. Extensive implementation of EHR in the Veterans Health Administration provides an opportunity for exploration. Our objective was to compare the performance of various approaches for predicting risk of cerebrovascular and cardiovascular (CCV) death, using traditional risk predictors versus more comprehensive EHR data. Regression methods outperformed the Framingham risk score, even with the same predictors (AUC increased from 71% to 73% and calibration also improved). …

A Neural Network Decision-Making Model For Job-Shop Scheduling”, Davood Golmohammadi Phd

Davood Golmohammadi

Scheduling in a job-shop system is a challenging task. Simulation modelling is a well-known approach for evaluating the scheduling plans of a job-shop system; however, it is costly and time-consuming, and developing a model and interpreting the results requires expertise. As an alternative, we have developed a neural network (NN) model focused on detailed scheduling that provides a versatile job-shop scheduling analysis framework for management to easily evaluate different possible scheduling scenarios based on internal or external constraints. A new approach is also proposed to enhance the quality of training data for better performance. Previous NN models in scheduling focus …

Data Mining Of Pancreatic Cancer Protein Databases, Peter Revesz, Christopher Assi

CSE Conference and Workshop Papers

Data mining of protein databases poses special challenges because many protein databases are non- relational whereas most data mining and machine learning algorithms assume the input data to be a type of rela- tional database that is also representable as an ARFF file. We developed a method to restructure protein databases so that they become amenable for various data mining and machine learning tools. Our restructuring method en- abled us to apply both decision tree and support vector machine classifiers to a pancreatic protein database. The SVM classifier that used both GO term and PFAM families to characterize proteins gave …

An Automated Pathological Class Level Annotation System For Volumetric Brain Images, Thien Anh Dinh, Tomi Silander, C. C. Tchoyoson Lim, Tze-Yun Leong

Research Collection School Of Computing and Information Systems

We introduce an automated, pathological class level annotation system for medical volumetric brain images. While much of the earlier work has mainly focused on annotating regions of interest in medical images, our system does not require annotated region level training data nor assumes perfect segmentation results for the regions of interest; the time and effort needed for acquiring training data are hence significantly reduced. This capability of handling high-dimensional noisy data, however, poses additional technical challenges, since statistical estimation of models for such data is prone to over-fitting. We propose a framework that combines a regularized logistic regression method and …

Bright Futures As-Is Assessment: How Child-Serving Practices, Health Systems, And The State Of Maine Use And Exchange Specific Clinical Data Related To Child Health Quality Measures, Kyra Chamberlain Ms, Rn, Martha Elbaum-Williamson Mpa, Jonathan Ives Mpm, Csm, Jin Liao M.Eng

Population Health & Health Policy

The purpose of the As Is assessment is to provide a description of Maine’s current HIT environment specifically pertaining to how EPSDT and other clinical data are entered, used, and exchanged electronically through information systems at pediatric practices, health systems, the State of Maine, and HIN. This information will inform plans currently under development by IHOC for electronic data exchange and child health measure calculation.

The Use Of Mobile Phone Cameras In Guiding Treatment Decisions For Laceration Care, Neal Sikka, Michael Pirri, Katrina Norbury Carlin, Ryan Strauss, Faisal Rahimi, Jesse M. Pines

Emergency Medicine Faculty Publications

Objectives: Mobile phone technology may be useful in helping to guide medical decisions for lacerations. We examined whether emergency department (ED) provider opinions on which lacerations require repair differed using mobile phone–generated images compared with in-person evaluations.

Subjects and Methods: Patients presenting to an urban ED for initial and follow-up laceration care were prospectively enrolled. Patients took four mobile phone pictures of their laceration and provided a medical history. Cases were reviewed by ED providers who assessed image quality and made a recommendation about whether the laceration needed repair. The same provider then assessed the patient in-person. Concordant decision-making between …

New Models For Medical Education: Web-Based Conferencing To Support Hiv Training In Sub-Saharan Africa, Michael J. A Reid, Robin Flam, Fatima Tsiouris

Botswana-UPenn Scholarly Publications

Background: Healthcare workers in Africa managing human immunodeficiency virus (HIV)-infected patients often receive inadequate HIV-specific medical education. The acceptability and feasibility of Web-based distance learning tools to enhance HIV training in Africa have not been extensively evaluated.

Materials and Methods: In this prospective observational study, we assessed the feasibility of Web-conferencing to deliver HIV-specific medical training to clinicians supporting HIV care and treatment across 12 Sub-Saharan African countries over a 10-month period. Webinar attendance, technical quality, and participant satisfaction were measured for each Webinar. Demographic details about participants were recorded.

Results: Attendance increased from 40 participants in Month 1 to …

Optimizing Network Connectivity For Mobile Health Technologies In Sub-Saharan Africa, Mark J. Siedner, Alexander J. Lankowski, Derrick Musinga, Jonathan Jackson, Conrad Muzoora, Peter W. Hunt, Jeffrey N. Martin, David Bangsberg, Jessica E. Haberer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Mobile health (mHealth) technologies hold incredible promise to improve healthcare delivery in resourcelimited settings. Network reliability across large catchment areas can be a major challenge. We performed an analysis of network failure frequency as part of a study of real-time adherence monitoring in rural Uganda. We hypothesized that the addition of short messaging service (SMS+GPRS) to the standard cellular network modality (GPRS) would reduce network disruptions and improve transmission of data.

Methods: Participants were enrolled in a study of real-time adherence monitoring in southwest Uganda. In June 2011, we began using Wisepill devices that transmit data each time the …

On The Way To Health, David A. Asch, Kevin G. Volpp

Issue Briefs

Information technology (IT) has fundamentally changed the way we work, bank, and communicate. Its impact on health care and health research, however, has been limited by the lack of a comprehensive infrastructure to connect patients, providers, and researchers. As we learn more about how to address the unhealthy behaviors that underlie many chronic conditions, researchers are seeking IT solutions to connect to patients in scalable ways. This Issue Brief describes the development and use of a new web-based IT platform, Way to Health, to deliver and evaluate behavioral interventions to improve health.

Meaningful Use And Meaningful Curricula: A Survey Of Health Informatics Programs In The U.S., Kai Koong, Madison Ngafeeson, Lai Lui

Journal Articles

The introduction of the US government’s Meaningful Use criteria carries with it many implications including the training curriculum of healthcare personnel. This study examines 108 health informatics degree programmes across the USA. First, the courses offered are identified and classified into generic classes. Next, these generic groupings are mapped to two important frameworks: the Learning to Manage Health Information (LMHI) academic framework; and the Meaningful Use criteria policy framework. Results suggest that while current curricula seemed acceptable in addressing Meaningful Use Stage 1 objective, there was insufficient evidence that these curricula could support Meaningful Use Stage 2 and …

Machine Learning Approach To Extract Diagnostic And Prognostic Thresholds: Application In Prognosis Of Cardiovascular Mortality, Luis J. Mena, Eber E. Orozco, Vanessa G. Felix, Rodolfo Ostos, Jesus D. Melgarejo, Gladys E. Maestre

School of Medicine Publications and Presentations

Machine learning has become a powerful tool for analysing medical domains, assessing the importance of clinical parameters, and extracting medical knowledge for outcomes research. In this paper, we present a machine learning method for extracting diagnostic and prognostic thresholds, based on a symbolic classification algorithm called REMED. We evaluated the performance of our method by determining new prognostic thresholds for well-known and potential cardiovascular risk factors that are used to support medical decisions in the prognosis of fatal cardiovascular diseases. Our approach predicted 36% of cardiovascular deaths with 80% specificity and 75% general accuracy. The new method provides an innovative …