Clinical Information Management System Research Articles

Development and Evaluation of a Data Quality Management System for the Korea Biobank Network.

As the reliance on clinical epidemiological information from human specimens grows, so does the need for effective clinical information management systems, particularly for biobanks. Our study focuses on enhancing the Korea Biobank Network's (KBN) system with data quality verification features. By comparing the quality of data collected before and after these enhancements, we observed a notable improvement in data accuracy, with the error rate decreasing from 0.1198% to 0.0492%. This advancement underscores the importance of robust data quality management in supporting high-quality clinical research and sets a precedent for the development of clinical information management systems.

Retracted: Construction of Clinical Pathway Information Management System under the Guidance of Evidence-Based Medicine.

[This retracts the article DOI: 10.1155/2021/4425449.].

Retracted: General Surgery Clinical Information Management System Based on Intelligent Data Management.

[This retracts the article DOI: 10.1155/2022/8601164.].

General Surgery Clinical Information Management System Based on Intelligent Data Management.

In order to improve the effect of surgical clinical information management, this paper combines the intelligent data management technology to construct the general surgery clinical information management system. Based on the design and development of general surgery clinical medical case information management system, this paper studies the mutual conversion between XML data and relational data, and designs a clinical medical case information management system based on the design idea of layered architecture. The clinical medical case information management system mainly adopts the modular design idea and adopts a digital microscopic image storage mode based on HDFS architecture. After building the system function structure, the system effect is verified by simulation test. From the experimental statistical results, it can be seen that the general surgery clinical information management system based on intelligent data management proposed in this paper has a good effect.

Common Data Model and Database System Development for the Korea Biobank Network

The importance of clinical information related to specimens is increasing due to the research on human biological specifications being conducted worldwide. In order to utilize data, it is necessary to define the range of data and develop a standardized system for collected resources. The purpose of this study is to establish clinical information standardization and to allow clinical information management systems to improve the utilization of biological specifications. The KBN CDM, consisting of 18 tables and 177 variables, was developed. The clinical information codes were mapped in standard terms. The 27 diseases in the group were collected from 17 biobanks, and all disorders not belonging to the group were standardized and loaded. We also developed a system that provides statistical visualization screens and data retrieval tools for data collection. This study developed a unified management system to model KBN CDM that collects standardized data, manages clinical information, and shares the information systematically. Through this system, all participating biobanks can be integrated into one system for integrated management and research.

Construction of Clinical Pathway Information Management System under the Guidance of Evidence-Based Medicine.

This study focuses on clinical pathways guided by evidence-based medicine (EBM). With the clinical pathway as the center, the subjective and objective medical knowledge of medical staff are collected, and a clinical pathway management system guided by EBM is established through a unified process; user demand analysis; main considerations; implementation, evaluation, and monitoring of the clinical path; and dictionary maintenance, to help hospitals fully regulate medical behaviors. Next, the study displays the path access prompt box, area 1 management page, table management page, exit prompt box, mutation record page, doctor order interface, revocation of execution, and monitoring interface, and the system designed is compared with the Beijing Shankang Technology (ASK) clinical data management system in terms of user experience. The results showed that the reporting rate of medical adverse events in the system in this study was 0.21%, and the work efficiency was increased by 14%. In terms of users' satisfaction, the hospital managers' satisfaction was 84 ± 5.36%, and it was 95 ± 4.72% for medical staff and 88 ± 4.91% for system administrators, superior to the ASK system; the differences were statistically significant (P < 0.05). In conclusion, the clinical pathway information management system is in line with the working environment of medical staff, and the synchronous monitoring and management of medical quality are achieved through digital means, which can reduce the occurrence of medical adverse events and improve the work efficiency of medical staff.

Qatar Biobank in the COVID-19 era and beyond

Background: During the COVID-19 outbreak, Qatar Biobank (QBB) adapted its services to collect, process, and store high-quality data and specimens. This transformation period brought opportunities, risks, and challenges. Methods: QBB holds College of American Pathologists (CAP) accreditation and International Organization for Standardization (ISO) certification for Quality Management (9001:2105) and Information Security Management Systems (27001: 2013). These standards helped to effectively convert its operations to facilitate the COVID-19 national project. The COVID-19 Biorepository is a National Disease-based study aiming to collect adequate health information and biological samples from Qatar residents infected by SARS-CoV-2 virus to enable evidence-based research towards the discovery and development of novel healthcare interventions and to facilitate research projects related to the COVID-19 pandemic. QBB IT Department used open-source Onyx (ObiBa) software to newly develop a COVID-19 electronic system and interface for various clinical devices and Laboratory Information Management System. QBB operational services were adapted to accommodate the COVID-19 project by providing training to the personnel (n = 20; i.e. nurses, research assistants etc.) and developing work instructions (n&gt;5) for the participants’ recruitment process, data and specimen collection in the different hospitals. A COVID-19 portal was also developed by QBB to facilitate data access for researchers from Qatar and worldwide. Results: Within 5 weeks QBB transformed to accommodate a disease/virus-based biorepository. At an operational level, multi-adjustments were implemented. QBB IT department developed an electronic system for the data collection and specimen traceability. Clinically trained staff were transferred to different healthcare facilities to recruit COVID-19 positive patients. QBB laboratory designed special collection kits. QBB Medical Review Office and Scientific and Education departments managed the recruitment process, set up of the study and provided training to the staff. The Communications and Participants Recruitment Department transformed its operations to fit the needs of the COVID-19 initiative. The Research Access Office designed the COVID-19 access portal and supported the project through purchasing of personal protective equipment and other administrative tasks. Conclusion: It is now time to consider lessons learned, as many countries have been affected by this pandemic, and to understand that biobanks are an asset for a country and there is a need to integrate them into a new standard with their sustainability in mind. Qatar Biobank is a good showcase of how a biobank can successfully assist in the collection of important data related to different health crises such as the COVID-19 pandemic.

Introduction to the human disease resource search and distribution platform through the Korea Biobank Network portal

Human-derived materials are a crucial element of research in the life sciences. The Korea Biobank Network (KBN) portal is a shared open platform that provides the nationʼs most extensive disease resources, possessed by Human Bioresource Unit Banks of the KBN, to the public, including those in the fields of industry, academia, and research. This platform was developed to increase the efficient use of national disease resources. In the KBN portal, the current status of disease resources collected in Korea can be checked online. Human bioresources and clinical information are provided to consumers through systematic search and efficient distribution programs. Additionally, by simultaneously operating the KBN Distribution Support Center, we are working to support the rapid and convenient distribution of human resources in response to the needs of consumers. To effectively utilize the open human bioresource sharing platform, it is necessary to introduce an integrated clinical information management system. Currently, the KBN is in the process of establishing standard terminology for data and applying a common data model for the integrated management of various clinical information held by the KBN. We provide communications through the KBN portal, which is interconnected with the distribution support center, regional biobanks, and consumers. In conclusion, the KBN portal will provide open innovation by creating a business or service model by delivering shared open data and internalizing external innovative capabilities.

P52 A baseline review of the activity of the PICU pharmacists using electronically captured data

AimTo date there are no metrics for the clinical pharmacist service to PICU. It is accepted that use of a Clinical Information Management System (CIMS) has a role in medication safety,1 however there are few studies that review the information potential of a CIMS for collecting pharmacist activity.2MethodAdditional fields and custom reports were configured in the CIMS to enable PICU pharmacists to record their activity in the following areas:Medicines reconciliation within 72 hours of admission to PICUDischarge kardex reviewAnalgesia and sedation (A&amp;S) reviewClinical pharmacy reviewOther interventions &amp; medication error reporting continued as per normal practice. Data was analysed using Microsoft Excel®.ResultsComplete data was available from July 2017 to end of 2018.There were 1274 medicines reconciliations by a pharmacist within 72 hours of admission (78% admissions). 14% of discharge kardexes had been reviewed prior to discharge to the ward. There was an average of 190 pharmacy reviews per 100 bed days. A total of 780 Pharmacist A&amp;S Plans were documented by the clinical pharmacists – an average of 2 per working day, and 48% of admissions.Comparisons between each six month period showed a significant increase in the number of pharmacists medicines reconciliations (p&lt;0.001). No other differences were found.ConclusionThis study has shown that electronic tracking of pharmacist ward activity is possible. It has the potential to demonstrate compliance with external or internal standards and audits. This data continues to be collected, and therefore these results will be used as a baseline to compare future activity. The findings of this study may encourage other units to replicate, providing data that can be used for comparison. Further configuration of the CIMS to capture other metrics such as TDM, and document discrepancies in medicines reconciliation is planned.ReferencesForni A, Chu H, Fanikos J. Technology Utilization to Prevent Medication Errors. Current Drug Safety. 2010;5:13–18.Nelson S, Poikonen J, Reese T, El Halta D, Weir C. The pharmacist and the EHR. Journal of the American Medical Informatics Association. 2016;24:193–197.Health and Information Quality Authority. Guidance for health and social care providers; Principles of good practice in medication reconciliation. Dublin: HIQA; 2014

Exploration on the Construction of Intensive Care Clinical Information Management System

This study introduces the feasibility study experience of intensive care clinical information management system in order to provide reference for the construction of intensive care clinical information management system in other hospitals. Four kinds of mainstream intensive care clinical information management system software were used to evaluate the implementation effect of each software such as equipment integration, information integration and application function module, so as to explore the construction scheme of intensive care clinical information management system. The optimized construction scheme and comprehensive feasibility study report of intensive care clinical information management system were formed, which provided an objective basis for the final scheme design, demonstration, procurement and decision-making of the hospital. The trial and feasibility study of intensive care clinical information management system contribute to optimize the construction scheme.

Design and practice of drug clinical trial information management system

Design and practice of drug clinical trial information management system

Development of data dictionary for neonatal intensive care unit: advancement towards a better critical care unit.

BackgroundCritical care units (CCUs) with extensive use of various monitoring devices generate massive data. To utilize the valuable information of these devices; data are collected and stored using systems like clinical information system and laboratory information management system. These systems are proprietary, allow limited access to their database and, have the vendor-specific clinical implementation. In this study, we focus on developing an open-source web-based meta-data repository for CCU representing stay of the patient with relevant details.MethodsAfter developing the web-based open-source repository named data dictionary (DD), we analyzed prospective data from 2 sites for 4 months for data quality dimensions (completeness, timeliness, validity, accuracy, and consistency), morbidity, and clinical outcomes. We used a regression model to highlight the significance of practice variations linked with various quality indicators.ResultsDD with 1555 fields (89.6% categorical and 11.4% text fields) is presented to cover the clinical workflow of a CCU. The overall quality of 1795 patient days data with respect to standard quality dimensions is 87%. The data exhibit 88% completeness, 97% accuracy, 91% timeliness, and 94% validity in terms of representing CCU processes. The data scores only 67% in terms of consistency. Furthermore, quality indicators and practice variations are strongly correlated (P < 0.05).ConclusionThis study documents DD for standardized data collection in CCU. DD provides robust data and insights for audit purposes and pathways for CCU to target practice improvements leading to specific quality improvements.

A crosswalk between the Omaha System and guiding undergraduate public health nursing education documents.

The Omaha System is the hallmark evidence-based clinical information management system used in nursing education, research, and practice. Multiple education documents guide public health workforce preparation. This qualitative study identified similarities and gaps between the Omaha System and seven guiding documents commonly used by nurse educators. A crosswalk design was employed. The setting was virtually based using online technology. Recommendations are for public health nurse educators to update their teaching practices using evidence-based approaches.

Investigation of clinical blood transfusion in Yantai City

Objective To investigate the current status of clinical blood transfusion in Yantai City from 2015 to 2016, analyze the weak links of clinical blood transfusion, and explore ways to strengthen clinical blood transfusion management. Methods Form 2015 to 2016, a total of 62 hospitals that signed blood supply agreements with the Yantai Central Blood Central Station were selected as research objects. According to the levels and charactoristics of the 62 hospitals, they were divided into tertiary general and public hospital group (n=12), secondary general and public hospital group (n=21), maternal and child health hospital group (n=5), first-class general and public hospital group (n=12), and private hospital group (n=12). In this study, primary hospitals included maternal and child health hospitals, first-class general and public hospitals and private hospitals. According to the Hospital Blood Transfusion Quality Evaluation and Assessment Form in Yantai City, on-site assessment of the infrastructure related to clinical blood transfusion in 62 hospitals was conducted. The questionnaires were used to investigate the implementaton of autologous blood transfusion in the 62 hospitals. A total of 510 clinical blood transfusion application forms and 270 clinical blood transfusion records were sampled randomly from 62 hospitals in January to June 2016, and the qualification rates of clinical blood transfusion application forms and clinical transfusion records were investigated. The chi-square test or the continuous correction chi-square test was used to compare the differences among hospitals of different groups or levels, which included proportions of hospitals evaluated by indicators of infrastructure related to clinical blood transfusion, implementaton rates of autologous blood transfusion, qualification rates of clinical blood transfusion application forms, and the composition ratio of clinical blood transfusion records of different grades. Results ① Among the 62 hospitals of this study, the proportion of hospitals that built clinical blood transfusion-related information management systems was 19.4% (12/62), proportion of hospitals that connected information with blood stations by internet was 8.1% (5/62), proportion of hospitals with separate blood transfusion department was 50.0% (31/62), proportion of hospitals participating in inter-room quality evaluation was 53.2% (33/62), proportion of hospitals that regularly organized clinical blood transfusion-related staffs to train was 77.4% (48/62), proportion of hospitals that took effective measures to evaluate reasonable clinical blood was 40.3% (25/62). The above 6 indicators of the secondary and tertiary general and public hospitals were significantly higher than those of the primary hospitals, and the differences were statistically significant (χ2=8.832, P=0.003; χ2=4.779, P=0.029; χ2=34.802, P<0.001; χ2=34.030, P<0.001; χ2=4.415, P=0.036; χ2=15.936, P<0.001). ② The total implementaton rate of autologous blood transfusion in 33 secondary and tertiary general and public hospitals in Yantai City was 51.5% (17/33). The implementaton rate of autologous blood transfusion in tertiary general and public hospital group was 83.3% (10/12), which was higher than that of 33.3% (7/21) in secondary general and public hospital group, and the difference was statistically significant (χ2=7.643, P=0.006). ③ In this study, the total qualified rate of 510 clinical blood transfusion application forms of the 62 hospitals was 82.7% (422/510). In evaluation of Cosistency of applying for blood use and application of blood component function , the overall difference in the qualified rates among 5 groups was statistically significant (χ2=31.141, P<0.001). ④ In this study, the total qualified rate of 270 clinical transfusion records in the 62 hospitals was 70.0% (189/270). The overall difference in composition ratios of qualified, partially qualified, and unqualified clinical blood transfusion records in 5 groups was statistically significant (χ2=66.221, P<0.001). Conclusions There is insufficient investment in clinical blood transfusion related infrastructure in hospitals at all levels in Yantai City, and the clinical blood transfusion related infrastructure of primary hospitals is relatively lagging behind. The autologous blood transfusion work and clinical blood transfusion management in some hospitals also need to be improved. The clinical blood transfusion management of some primary hospitals needs to be strengthened, and the competent authorities should strengthen the evaluation of the blood transfusion quality of these hospitals. Key words: Blood transfusion; Blood transfusion, autologous; Blood safety; Blood transfusion management; Clinical blood transfusion

INTEGRATED MEDICAL DATA MANAGEMENT SYSTEMS REVIEW

In recent years we’ve seen breakthrough research success in medicine and computer science enabled by novel technology advancements, data analyses capabilities and learning techniques. Despite this, quality care doesn’t have full cove­ rage even in developed countries and access to care is recognised as one of the biggest challenges to the global healthcare system. Bound with population growth in remote areas in developing regions, which lack skilled professionals and medical resources, as well as aging in developed countries this caused a strong need for increasing healthcare effectiveness. Enabled by development of cloud technologies, quick expansion of mobile network coverage and internet access Clinical Information Management Systems integrated with decision support systems, Telemedicine (inclu­ ding distributed Virtual Healthcare Teams and medical imaging), Mobile Healthcare, medical Internet of Things (mIoT), Consumer Health Informatics with personal intelligent health assistants, Health Information Exchanges and deep learning techniques for diagnostics and knowledge extraction are among the state-of-the-art solutions which are more or less successfully used for coping with the problem mentioned above. This paper reviews current situation with implementing these novel informational systems, analyses their advantages, drawbacks, implementation impediments and outcome effectiveness suggesting platform for empowering their integration and maximizing output of each module. Such solution will have a synergy effect and result in a drastic increase of medical resource utilization effectiveness, service quality and providing bigger and fuller coverage with less spending at the same time empowering knowledge exchange process and laying foundation for future development and innovations in the whole healthcare domain.

Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort: study protocol and results of the first 3 years of enrollment.

Although the etiologies of cardiovascular disease (CVD) are widely understood, the goal of finding a globally effective solution for preventing CVD is unrealistic. Therefore, we aimed to conduct a community-based prospective study on the prevention and management of CVD in Korean adults. This study was designed to recruit 8,000 healthy adults over the course of 5 years. The baseline assessment includes a wide range of established CVD risk factors, including demographic characteristics, medical history, health behaviors, psychological conditions, body size and composition, blood pressure, the augmentation index, carotid ultrasonography, an electrocardiogram, and biochemical indicators, as well as some novel factors, such as social network characteristics, exposure to environmental pollutants, inflammatory markers, hemostatic markers, and immunosenescence markers. Annual telephone interviews and follow-up health examinations at 5-year intervals after the baseline assessment are planned to collect information on changes in health status and its determinants. Additionally, indirect follow-up using secondary data sources will be conducted to obtain information on health services utilization and death. So far, more than 6,000 adults have been enrolled during the first three and a half years, and almost all participants have been tracked by annual telephone follow-up surveys. The data have been uploaded to iCReaT, the clinical research information management system of the Korea National Institute of Health.

Electronic medical records in humanitarian emergencies - the development of an Ebola clinical information and patient management system.

By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. Data continued to also be recorded on paper charts, creating theoretically identical record "pairs" on paper and tablet. 83 record pairs for 33 patients with 22 data items (temperature and symptoms) per pair were analysed. The overall Kappa coefficient for agreement between sources was 0.62, but reduced to 0.59 when rare bleeding symptoms were excluded, indicating moderate to good agreement. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge differences in organisational culture between the technology and humanitarian worlds. This investment is essential for establishing a shared vision on deliverables, urgency, and ownership of product.

Electronic medical records in humanitarian emergencies – the development of an Ebola clinical information and patient management system

By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. Data continued to also be recorded on paper charts, creating theoretically identical record "pairs" on paper and tablet.85 record pairs for 32 patients with 26 data items (temperature and symptoms) per pair were analysed. The average agreement between sources was 85%, ranging from 69% to 95% for individual variables. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge differences in organisational culture between the technology and humanitarian worlds. This investment is essential for establishing a shared vision on deliverables, urgency, and ownership of product.

Electronic medical records in humanitarian emergencies – the development of an Ebola clinical information and patient management system

By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. Data continued to also be recorded on paper charts, creating theoretically identical record “pairs” on paper and tablet. 83 record pairs for 33 patients with 22 data items (temperature and symptoms) per pair were analysed. The overall Kappa coefficient for agreement between sources was 0.62, but reduced to 0.59 when rare bleeding symptoms were excluded, indicating moderate to good agreement. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge differences in organisational culture between the technology and humanitarian worlds. This investment is essential for establishing a shared vision on deliverables, urgency, and ownership of product.

Electronic medical records in humanitarian emergencies – the development of an Ebola clinical information and patient management system

By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. 85 record “pairs” for 32 patients with 26 data items (temperature and symptoms) per pair were analysed. The average agreement between sources was 85%, ranging from 69% to 95% for individual variables. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge differences in organisational culture between the technology and humanitarian worlds. This investment is essential for establishing a shared vision on deliverables, urgency, and ownership of product.