Health Information Technology Commons^™

Interlace: Designing An Inclusionary Architecture For Alzheimer's Sufferers, Alexander Fashinasi

Bachelor of Architecture Theses - 5th Year

This thesis intends to address the increasing challenges the Alzheimer’s disease poses for our growing American population. The research begins by looking at the brain as a combination of components which make up the individual. Following this, the research compiles information on the Alzheimer’s disease and its symptoms, followed by an analysis of the built environments effects on the condition.

Through analysis of precedent cases and the combined Alzheimer’s research, I chose to propose an experimental community in which those with Alzheimer’s can live a life with greater autonomy while simultaneously slowing the progression of the disease. I place this …

Mobile Personal Health Monitoring For Automated Classification Of Electrocardiogram Signals In Elderly, Luis J. Mena, Vanessa G. Felix, Alberto Ochoa, Rodolfo Ostos, Eduardo Gonzalez, Javier Aspuru, Pablo Velarde, Gladys E. Maestre

School of Medicine Publications

Mobile electrocardiogram (ECG) monitoring is an emerging area that has received increasing attention in recent years, but still real-life validation for elderly residing in low and middle-income countries is scarce. We developed a wearable ECG monitor that is integrated with a self-designed wireless sensor for ECG signal acquisition. It is used with a native purposely designed smartphone application, based on machine learning techniques, for automated classification of captured ECG beats from aged people. When tested on 100 older adults, the monitoring system discriminated normal and abnormal ECG signals with a high degree of accuracy (97%), sensitivity (100%), and specificity (96.6%). …

Utilization Of Telehealth Technology In Addiction Treatment In Colorado, J. Michael Faragher, Ying Shan Doris Zhang, Virginia Low, Demi Folds, Mita Johnson

Counseling Psychology: Faculty Scholarship

The growing presence of electronic technology in the health service professions is redefining the boundaries of counseling services. Commonly referred to as telehealth, utilization of electronic communication strategies to expand connectedness has opened new frontiers in behavioral health through applications ranging from digital phones, interactive video sessions, to virtual supervision. Substantial research suggests that telehealth is generally equal in effectiveness to traditional forms of treatment, especially for those individuals struggling with substance abuse problems. Unfortunately, research also suggests that telehealth is often underutilized when it comes to providing addiction treatment services. Telehealth trends in Colorado were examined using a Telehealth …

A Patient Portal Push Toward Acceptance And Utilization Of The Technology, Deborah Kornacker, Kathy Fitzgerald, Stacie Elder

Nursing Department Graduate Theses/Dissertations

Certified electronic health record technology (c-EHRT) has the capacity to enhance person-centered care through online engagement between providers and patients. A driver to portal use is the Centers for Medicare and Medicaid (CMS) Meaningful Use (MU) benchmarks. Currently, many health care centers and providers fall short in attracting patients to register and utilize online patient portals thus influencing optimal utilization of the EHR. Barriers cited in the literature include lack of stakeholder interest, multiple government policy and mandates, and lack of resources to implement standards for health information technology (HIT) standards in daily professional workflow. This program evaluation focused on …

Development Of A Journaling Application To Track Progress Of Adaptation To Amplification For Adult Patients: Deardiary, Nicole C. Snider

Dissertations, Theses, and Capstone Projects

The DEar Diary application is an illustration of concept of an Apple iOS (operating system) application designed as a tool for supporting compliance and satisfaction with the use of amplification. The audiologist’s main purpose is to counsel, support and to provide rehabilitative counseling to their patients. Helping a patient succeed while using hearing devices for the first time is a complicated task which can be accomplished with the proper counseling and helpful tools in place.

The use of a journal to write down experiences and providing written support material the patient can refer to once they are out of the …

May 2018, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

No abstract provided.

Cross-Participant Eeg-Based Assessment Of Cognitive Workload Using Multi-Path Convolutional Recurrent Neural Networks, Ryan G. Hefron, Brett J. Borghetti, Christine M. Schubert Kabban, James Christensen, Justin Estep

Faculty Publications

Applying deep learning methods to electroencephalograph (EEG) data for cognitive state assessment has yielded improvements over previous modeling methods. However, research focused on cross-participant cognitive workload modeling using these techniques is underrepresented. We study the problem of cross-participant state estimation in a non-stimulus-locked task environment, where a trained model is used to make workload estimates on a new participant who is not represented in the training set. Using experimental data from the Multi-Attribute Task Battery (MATB) environment, a variety of deep neural network models are evaluated in the trade-space of computational efficiency, model accuracy, variance and temporal specificity yielding three …

An Exploration Of Patients’ Experience Of Nurses’ Use Of Point-Of-Care Information Technology In Acute Care, Leigh Mcnicol, Anastasia F. Hutchinson, Beverley Wood, Mari Botti, Bernice Redley

Patient Experience Journal

The rapid introduction of technology into acute healthcare settings, specifically the presence of point-of-care health information technology at patients’ bedsides, is expected to impact patients’ healthcare experience by altering nurse-patient interactions. This research was a multi-method naturalistic pilot study designed to explore patients’ perception of their interactions with nurses using bedside point-of-care health information technology in acute care. Data were collected using observation, interviews and surveys. Twenty-four participants were purposefully recruited from medical and surgical wards, to capture variability in their self-reported confidence with information technology; 29% were not confident, 38% were somewhat confident and 33% were completely confident with …

How Laboratory Informatics Has Impacted Healthcare Overall, Mohammad Rafid Raeen

Applied Research Projects

Health information technology has improved key areas of healthcare such as academia, research, and practice. Technology is one of the key driving forces in healthcare that is set to enhance the overall provider-patient experience. The future of healthcare is aimed at improving patient satisfaction, quality of care, and practice methods. Laboratory information systems (LIS) is a fundamental component of the diagnostic or pathology department (Henricks, 2016). In the era, where laboratory reports have become complex and high-dimensional, the need to develop and implement a cost-effective platform or tool to collect, process, store, and manage such processes is required. A systematic …

Identifying Barriers That Affect Patients Access To Their Patient Portals And Mhealth Applications, Rameria L. Stewart

Applied Research Projects

Technological advances have generated new resources that allow patients to be more involved in their healthcare. As different innovations find their way into the informatics sector of healthcare, patients experience some challenges as they try to adopt these innovations. One particular innovation in healthcare has been the use of patient portals to promote patient engagement, which will encourage patients to take on a more active role in their healthcare. This study focused in exploring the barriers in the access of MyChart portal at Baptist Memorial Care Corporation and, to some extent, how to handle this problem. An online survey …

Analysis Of College Students’ Personal Health Information Activities: Online Survey, Sujin Kim, Donghee Sinn, Sue Yeon Syn

Internal Medicine Faculty Publications

Background: With abundant personal health information at hand, individuals are faced with a critical challenge in evaluating the informational value of health care records to keep useful information and discard that which is determined useless. Young, healthy college students who were previously dependents of adult parents or caregivers are less likely to be concerned with disease management. Personal health information management (PHIM) is a special case of personal information management (PIM) that is associated with multiple interactions among varying stakeholders and systems. However, there has been limited evidence to understand informational or behavioral underpinning of the college students’ PHIM activities, …

Primary Care Practices’ Progress Of Using Electronic Health Information Exchange (Hie), Susan M. Heyde

Applied Research Projects

Now that EHRs are purportedly fully implemented in the healthcare industry, it is important to evaluate the electronic Health Information Exchange (HIE) between primary care facilities, laboratories, hospitals, specialists, regional coops, and public health authorities.

Meaningful Use Stage 3 implementation is to begin this year, 2018. Complementing this implementation, the Medicare Access and CHIP Reauthorization Act, MACRA, was signed into law on April 16, 2015. MACRA removes eligible clinicians from EHR Incentive Programs that were previously established by the HITECH Act. MACRA also creates the Quality Payment Program that the CMS will use for Medicare and Medicaid reimbursement to primary …

The Importance Of Clinical Documentation Improvement, Amanda Shanty Baksh

Applied Research Projects

The world of technology in the twenty first century is forever expanding. In the healthcare field, patient data has transformed from paper charts into electronic health records. Electronic health records allow for organized patient information however, an enormous amount of information becomes available. Sometimes the massive amount of information is not always needed but important detail the medical chart is looked for by insurance companies for reimbursement. There is a special department in hospitals called the Clinical Documentation Improvement specialists who are made up of experienced medical coders, registered nurses, mid-level practitioners such as nurse practitioner’s s or physician’s assistants …

April 2018, Randy Curry, Cindy Brooks

RURAL ROCKS

Rural Rocks, the Rural Health Network newsletter by the SWOSU College of Pharmacy

Exploring Standardized Nursing Languages: Moving Toward A Faith Community Nursing Intervention, Deborah J. Ziebarth

International Journal of Faith Community Nursing

There are many benefits when a specialty is able to translate nursing interventions into a standardized language. One of the benefits is that nurses from different specialties, geographic areas, or countries are able to understand terminologies and concepts. The aim of this paper is to examine three standardized nursing languages and their use in describing faith community nursing through an integrative literature review.

General descriptions, recognitions, populations, translations, reliability/validation/utility, and components of the Omaha System, the Nursing Intervention Classification, and the International Classification for Nursing Practice were presented. The author did not find literature to support the use of one …

Adult Patients Living With Human Immunodeficiency Virus Hospitalized For Community-Acquired Pneumonia In The United States: Incidence And Outcomes, Leslie A. Beavin, Stephen P. Furmanek, Paula Peyrani, Anupama Raghuram, Forest W. Arnold, Mark Burns, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Community-acquired pneumonia (CAP) is a common infectious reason for hospitalization of adults in the United States (US), including those with Human Immunodeficiency Virus (HIV). While there are studies detailing the incidence and outcomes for all adults with CAP we are not aware of a recent study detailing incidence and outcomes in adult HIV patients hospitalized with CAP. The objectives of this study were (1) to define the current incidence and outcomes of adult HIV patients hospitalized with CAP in Louisville, Kentucky, and (2) to estimate the burden of CAP in the US HIV adult population.

Methods: This was a …

A Software Tool For Automated Upload Of Large Clinical Datasets Using Redcap And The Capo Database, William A. Mattingly, Christopher Sinclair, Danna Williams, Matthew Grassman, Stephen Furmanek, Kimberley Buckner, Mohammad Tahboub

The University of Louisville Journal of Respiratory Infections

Introduction: Obtaining clinical data from healthcare sources is necessary for conducting clinical research. New technologies now allow for connecting a research database to Electronic Medical Records remotely, allowing the automatic import of clinical research data. In this paper we design and evaluate a REDCap extension to import clinical records from an external health database.

Methods: Many hospital EHRs are designed to use secure file transfer protocol (SFTP) repositories for data communication. We develop a REDCap plugin to connect to an external SFTP file repository for the import of clinical record data. We use the CAPO instance of REDCap and a …

Bacteremic Pneumococcal Pneumonia: A Longitudinal Study In 279 Adult Patients From A Single Center, Jorge H. Gentile, Claudia Hernandez, Monica D. Sparo, Edgardo M. Rodriguez, Carolina Ceriani, Florencia Bruggesser

The University of Louisville Journal of Respiratory Infections

Background: Bacteremic pneumococcal pneumonia (BPP) is the most common clinical presentation of invasive pneumococcal disease (IPD). Although it has been extensively studied, there is little knowledge in our region in relation to burden of disease, demographic and outcome features.

Methods: We conducted a prospective, longitudinal, observational study from 1989 to 2015 in adult patients with BPP, in order to deepen our knowledge of the characteristics of this disease in our community hospital in Tandil, Argentina.

Results: 279 patients were included. The mean incidence was 2.8/1000 admissions with a sharp decrease in the last two years, reaching 0.8/1000 admissions. Mean patient …

An Hiv-Positive Patient With Copd Admitted To The Icu With Respiratory Failure, Bhavani Puskur, Veronica Corcino, Srikant Ramachandruni, Viswanathan Nagarajan, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Non-Resolving Community Acquired Pneumonia (Cap) Due To Blastomyces Dermatitidis (Pulmonary Blastomycosis): Case Report And Review Of Literature, Johnson Britto

The University of Louisville Journal of Respiratory Infections

In this case report, we describe a case of progressive acute pulmonary blastomycosis in a healthy adult living in Kentucky, initially presenting with flu like illness with a left sided consolidation, who did not respond to antibiotic therapy. Patient’s clinical condition deteriorated with development of necrotizing bronchopneumonia, mediastinal lymphadenopathy, tree-in-bud reticulonodularity and pleural effusion. A diagnosis of progressive pulmonary blastomycosis was established by radiological findings as well as transbronchial needle aspiration cytology and bronchoalveolar lavage culture demonstrating Blastomyces dermatitidis. Patient showed significant clinical improvement with resolution of pulmonary lesions on antifungal treatment. Since symptoms of blastomycosis are often similar to …

Effectiveness Of The Influenza Vaccine In Preventing Hospitalizations Of Patients With Influenza Community-Acquired Pneumonia, Thomas Chandler, Stephen P. Furmanek, Connor L. English, Connor Glick, Wesley Trail, Lara Daniels, Ugochukwu Owolabi, Ruth Carrico, Julio A. Ramirez, Timothy L. Wiemken

The University of Louisville Journal of Respiratory Infections

Introduction: Influenza vaccination is the primary strategy for prevention of influenza infection. Influenza infection can vary from mild or even asymptomatic illness to severe community-acquired pneumonia (CAP). Although many national and international investigators and organizations report annual estimates of influenza vaccine effectiveness for prevention of influenza infection in the community, few studies report estimates for the prevention of hospitalizations due to influenza CAP, the most severe form of the infection. The objective of this study is to determine the effectiveness of the influenza vaccine for prevention of hospitalization in patients with influenza-associated CAP.

Methods: This was a test-negative study using …

Duration Of Antibiotic Therapy For Patients With Bacteremic Staphylococcus Aureus Community-Acquired Pneumonia, Julio A. Ramirez, Thomas File, Daniel Musher

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Real-Time Pcr Detection Of Mycoplasma Pneumoniae, Chlamydia Pneumoniae And Legionella Pneumophila In Respiratory Specimens Using The Aries® System, Subathra Marimuthu, Leslie A. Wolf, James T. Summersgill

The University of Louisville Journal of Respiratory Infections

Background: Mycoplasma pneumoniae (Mpn), Chlamydia pneumoniae (Cpn), and Legionella pneumophila (Lpn) can cause both epidemic and endemic occurrences of acute respiratory disease and are responsible for up to 22% of cases of community acquired pneumonia. Due to the limited availability of FDA-approved molecular diagnostic assays, we developed and evaluated a multiplexed Real-time PCR assay for the detection of these agents in two respiratory specimen types on the Luminex ARIES® instrument. The instrument provides for nucleic acid extraction plus PCR amplification and target detection in the same cassette. The ARIES® instrument generates a cycle threshold value and a confirmatory melt curve …

Communication Between Clinicians And The Hospital-Based Microbiology Laboratory: Strategies For 2018 And Beyond, Hans H. Liu

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Mycobacterium Kansasii As The Primary Etiology Of Pulmonary Infections Due To Non-Tuberculous Mycobacterium (Ntm) In Patients Without Human Immunodeficiency Virus (Hiv): Experience From A Center In Buenos Aires, Argentina, Gabriel Yusti, Marcela Heres, Alejandra González, Mariano Fielli, Adrian Ceccato, Alejandra Zapata

The University of Louisville Journal of Respiratory Infections

Introduction: Pulmonary diseases due to non-tuberculous mycobacterium (NTM) lung infection in HIV-negative patients are rarely described in the literature. Currently, NTM consist of more than 150 species, and they are globally ubiquitous in both natural and man-made environments.The objective of this study was to define the most frequent species of NTM causing pulmonary disease in HIV-negative patients in the city of Buenos Aires, Argentina. The prevalence of pulmonary diseases caused by NTM is difficult to determine since the isolation of NTM does not necessarily indicate disease.

Methods: A retrospective review of all the respiratory cultures positive for NTM in the …

Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, The Clinical Research Coordinating Center Team

The University of Louisville Journal of Respiratory Infections

Insufficient infrastructure is one of the challenges facing investigators in the field of clinical research. At the University of Louisville (UofL) Division of Infectious Diseases, we developed a multidisciplinary coordinating center with the aim to support investigators in all aspects of the clinical research process. The objective of this article is to describe the composition and the role of the different units of the UofL Clinical Research Coordinating Center. The different components of the Center can serve as a template for institutions interested in developing a clinical research support infrastructure.

Clinical Research: From Idea To Publication, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Julio A. Ramirez, M.D., FACP, Professor of Medicine/Associate Professor of Microbiology and Immunology; Chief, Division of Infectious Diseases; Director, Infectious Diseases Fellowship Training Program and Founding Director, Global Health Initiative at The University of Louisville, presented "Clinical Research: From Idea to Publication" at University of Louisville Department of Medicine Grand Rounds on February 15, 2018. The talk focused on performing an overview of clinical study designs, describing the planning and performing of a clinical study, reviewing the process for statistical and clinical analysis, and presenting the structure of a Clinical Research Coordinating Center.

Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, Andrea Reyes-Vega

Faculty and Staff Scholarship

Insufficient infrastructure is one of the challenges facing investigators in the field of clinical research. At the University of Louisville (UofL) Division of Infectious Diseases, we developed a multidisciplinary coordinating center with the aim to support investigators in all aspects of the clinical research process. The objective of this article is to describe the composition and the role of the different units of the UofL Clinical Research Coordinating Center. The different components of the Center can serve as a template for institutions interested in developing a clinical research support infrastructure.

Abstracts From The 24th Annual Health Care Systems Research Network Conference, April 11–13, 2018, Minneapolis, Minnesota

Journal of Patient-Centered Research and Reviews

Founded in 1994, the Health Care Systems Research Network (HCSRN) is a consortium of 18 research centers that are housed in community-based health systems. The organization's annual conference serves as a venue for research teams to disseminate scientific findings, stimulate new collaborations, and share insights about conducting research in real-world care-delivery settings. Abstracts accepted for presentation at HCSRN 2018 are published within this supplement of the Journal of Patient-Centered Research and Reviews.

Healthcare Facilities: Another Target For Ransomware Attacks, David P. Paul Iii, Nikki Spence, Niharika Bhardwa, Alberto Coustasse Dr.Ph, Md, Mba, Mph

Management Faculty Research

Ransomware is a type of malware used by cyber criminals who encrypt files and then extort money in return for unlocking those files. Without adequate disaster recovery and backup plans, many businesses are forced to pay the ransom. We examine recent ransomware infections in healthcare settings, the liabilities and cost associated with such infections, and discuss possible risk mitigation tactics. Risks associated with ransomware attacks on healthcare facilities include financial, future business loss and damage to reputation. Healthcare facilities should have a disaster plan with adequate data backups and educate employees who are the usual sources of ransomware attacks.