Electronic Health Information Management Research Articles

Drug Discovery and the Role of Artificial Intelligence in Human Healthcare

Abstract: The integration of artificial intelligence (AI) into healthcare and drug development has catalyzed an era of change in medical research and patient care. This research paper examines the evolving landscape of drug development and highlights the central role of artificial intelligence in advancing human healthcare. By combining data-driven approaches with advanced machine learning algorithms, AI can transform target identification, molecular screening, lead optimization and clinical trial design. In healthcare, AI applications include medical image analysis, disease diagnosis, personalized medicine, electronic health information management and more, promising better patient care, cost reduction and advances in medical research. However, these innovations come with challenges such as data protection, bias, regulatory barriers and ethical issues. The article highlights the potential of AI in drug development and healthcare and discusses similar AI-based solutions and methods. It also addresses issues related to data protection, interoperability, data quality, regulatory approval, ethical issues and resource constraints. Responsible development and implementation are critical to the safety and effectiveness of healthcare AI applications. Future work includes improving explainability, promoting knowledge sharing and collaboration, creating ethical frameworks, adapting regulatory processes, integrating AI into clinical practice, and addressing global health disparities. Through collaboration and continued research, AI holds the promise of revolutionizing healthcare, leading to better patient outcomes and a brighter future for medicine.

The changes in health service utilisation in Malawi during the COVID-19 pandemic.

The COVID-19 pandemic and the restriction policies implemented by the Government of Malawi may have disrupted routine health service utilisation. We aimed to find evidence for such disruptions and quantify any changes by service type and level of health care. We extracted nationwide routine health service usage data for 2015-2021 from the electronic health information management systems in Malawi. Two datasets were prepared: unadjusted and adjusted; for the latter, unreported monthly data entries for a facility were filled in through systematic rules based on reported mean values of that facility or facility type and considering both reporting rates and comparability with published data. Using statistical descriptive methods, we first described the patterns of service utilisation in pre-pandemic years (2015-2019). We then tested for evidence of departures from this routine pattern, i.e., service volume delivered being below recent average by more than two standard deviations was viewed as a substantial reduction, and calculated the cumulative net differences of service volume during the pandemic period (2020-2021), in aggregate and within each specific facility. Evidence of disruptions were found: from April 2020 to December 2021, services delivered of several types were reduced across primary and secondary levels of care-including inpatient care (-20.03% less total interactions in that period compared to the recent average), immunisation (-17.61%), malnutrition treatment (-34.5%), accidents and emergency services (-16.03%), HIV (human immunodeficiency viruses) tests (-27.34%), antiretroviral therapy (ART) initiations for adults (-33.52%), and ART treatment for paediatrics (-41.32%). Reductions of service volume were greatest in the first wave of the pandemic during April-August 2020, and whereas some service types rebounded quickly (e.g., outpatient visits from -17.7% to +3.23%), many others persisted at lower level through 2021 (e.g., under-five malnutrition treatment from -15.24% to -42.23%). The total reduced service volume between April 2020 and December 2021 was 8 066 956 (-10.23%), equating to 444 units per 1000 persons. We have found substantial evidence for reductions in health service delivered in Malawi during the COVID-19 pandemic which may have potential health consequences, the effect of which should inform how decisions are taken in the future to maximise the resilience of healthcare system during similar events.

Sociotechnical factors of sustainable digital health systems: A system dynamics model

BackgroundThe introduction of digital health technology in a healthcare facility results in emergent and recursive interactions between new technology and existing social systems, technologies, and operating environments. ObjectivesThe study aims at developing a sociotechnical system dynamics model of digital health systems to assess the influence of sociotechnical factors on the sustainable use of an electronic Health Information Management System (eHMIS). MethodsA total of 40 face-to-face interviews in 18 healthcare facilities and two separate sessions of focus group discussions were conducted to study eHMIS implementation in Ethiopia. A system dynamics modelling of digital health systems implementation is developed, tested and verified with a case of eHMIS implementation in Ethiopia. ResultsThe long-term sustainability of the digital health system requires acceptance of technology, improved information quality to make appropriate decisions and better end-user satisfaction. The ‘individuals’ intention to use’ drives technology acceptance in the early years of the eHMIS use and social factors in the later stage. Besides, the role of technology to improve work performance determines the level of users’ satisfaction. The effort of improving ‘information quality’ is strongly influenced by the quality systems, i.e., reliable, easy to use, and capable to meet end-user requirements. ConclusionsThe system's acceptance was improved through effective training and communication, whereas the ‘information quality’ was enhanced through ‘system quality’ and users’ satisfaction. The ability of technology to improve work performance and reduce the burden on end-users has increased the satisfaction of end-users.

Normalisation of electronic medical records in routine healthcare work amidst ongoing digitalisation of the Philippine health system

By drawing perspectives from the multi-level perspectives in sociotechnical transition and the normalisation process theory, this article explores how ongoing (i.e., incomplete) national level reforms in health information management (HIM) shape the normalisation of electronic medical records (EMRs) in Philippine rural health work. Based on document review, interviews, and observations, we argue that an ongoing HIM regime transition—transitioning from paper-based to an electronic HIM regime—may exert ambivalent institutional pressures on health workers through their institutions’ implementation context. The ambivalence of the implementation context—one that accommodates both EMR and paper-based medical records—offers conflicting social, cognitive, and material resources for normalising EMRs. In such a context, we find that health workers performed selective participation and partial implementation in normalising EMRs in their routine healthcare work. In selective participation, select health workers—often, the technologically savvy—could actively participate in the EMR implementation while others focused on their clinical work. At the same time, since only a few could use the EMR in routine work, EMRs were implemented partially in particular instances where it is deemed more valuable and applicable. We emphasised in this article how complementing the idea of normalisation with sociotechnical transition may reveal the emergence of pressures from various institutions and stakeholders that advances (or impede) the normalisation of healthcare innovations.

SAT-131 EVALUATION OF RENAL DATA QUALITY: A PREPARATORY STEP FOR A RENAL REGISTRY IN AN ISN/SRC CENTER, IN PORT HARCOURT, NIGERIA

The impact of renal registries that promote service planning, disease management, quality improvement, and research is dependent on the quality of baseline data. Inadequate baseline data collection tools and the low utilization of electronic Health Information Management Systems (eHIMs) are key challenges to the development of renal registries in Africa as stated by the African Regional Association of Nephrology (AFRAN). This state of affairs prompted the baseline assessment of renal data quality and the development of a structured data collection tool as a prerequisite for the commencement of a community-level primary care renal service and the establishment of the local renal registry at an ISN/SRC center, at the University Port Harcourt Teaching Hospital, Nigeria, Patients' data were extracted from physical records for the period 2015 to 2018 and entered on renal registry template based on a modified WHO Steps instrument proposed by the South Africa Medical Research Council. CKD Africa Collaboration. The tool had 10 domains of Demographic and general information (DGI), Behavioural measurements (BM), Cardiovascular risk, CKD Risk and Past medical history (CVCKRisk), Physical measurements (Anthropometric and metabolic) (PM), Measures of kidney function (MKF), Measures of chronic kidney disease impact (CKDI), Renal Imaging (RI), CKD Course and outcome (CKDCO), Renal Histology (RH) and Renal Replacement Therapy (RRT) with a total of 67 items. Three domains and 20 items were excluded in the analysis which focused on the data quality dimension of completeness. There were 1099 patient entries, with an overall data completeness range of 14.16 – 99.42%. The range and mean of data completeness in percentages (%) for 7 domains were DGI: 76.50 – 99.42, 87.92±13.18, BM: 95.18 - 96.79, 96.01±0.81, CVCKRisk: 16.93 - 93.43, 81.26±24.78, PM: 35.62 -94.74, 76.94±24.02, MKF: 31.97 - 77.52, 54.33 ±23.66, CKDI: 14.16 - 77.52, 48.06 ±24.93, RI: 33.58 - 38.98, 36.5840 ±2.66 respectively. There were significant differences in the mean completeness within and across the domains. The BM Domains had the highest mean completion rate of 96.01±0.81%, while the highest item completion rate of 99.42% and 99.27% was attained in demographic information items such as gender and age respectively. The lowest rates of 31.97%, 14.16% and 33.58% respectively were recorded in MKF, CKDI and RI items such as urine albumin, mineral bone disease parameters, and renal imaging measurements. There are significant gaps in data completeness with the current data tools used in the facility. The poor data quality limits the integrative capacity of the renal data from this center to other sub-regional and national registries. The lack of a structured data tool also limits the implementation of standardized community based renal care service. In response to this assessment, a structured data collection and patient assessment tool were developed to improve data quality and make the establishment of a local registry achievable. It is advocated that the assessment of facility data quality and the development of structured data tools are important perquisites in promoting standardized community based renal care, renal data quality, and successful registry development in technologically challenged environments.

A Model for an Electronic Health Information Management System with Structural Interoperability in Heterogeneous Environments for continued Health Care

Electronic Health Records (EHR) Systems have over the recent years become an integral part of any effective Health Care System. Volumes of data is kept in heterogeneous systems and though continued health care highly depends on knowledge acquired from medical history captured at various points, this information is usually not readily available. This is caused by lack of interoperability and use of standards. Usually, interoperability has been targeted at health systems communicating amongst themselves and not with other supporting systems such as administrative systems that may be directly affected by healthcare systems or may themselves affect healthcare systems.
 The University of Zambia (UNZA) Clinic EHR does not interoperate with administrative systems systems. This study proposes a model to improve the efficiency of healthcare at UNZA Clinic by introducing an EHR system that applies interoperability with the University’s Human Resource and Student Information Systems at as less a cost a possible. The study was guided by two (2) objectives. A baseline study was conducted to evaluate the performance of the currently implemented modules of the Electronic System at UNZA Clinic to address objective number (1). 200 questionnaires were distributed during clinic visits with 150 of them being used to collect data from within University community. Of these, 50 were given to members of staff that benefit from the health services, 75 to students and 50 to the healthcare providers. The remaining 25 questionnaires were shared amongst staff dependents and the community outside the University.
 Our results show that there is potential to improve on patient delay time. Many respondents suggested that automating the processes and securely sharing electronic records amongst the offices that attend to them would better the service. A model has been proposed to address objective 2 for the design of a prototype that adheres to HL7 EHR Standards. In order to achieve an interoperable eHealth Records System, we have investigated and proposed a Web Service architecture.

An Assessment of Participant-Described Interprofessional Oral Health Referral Systems Across Rurality.

As a means to identify and quantify oral health interprofessional collaborative practice (IPP), we examined participant-described medical-to-dental (M2D) referral networks and how they function across rurality. We conducted a cross-sectional survey on the appraisal of IPP referral systems in 2016. Secondarily, we examined if rural health clinics (RHCs) have different experiences with M2D referrals compared to other practice types. Independent variables included geographic and organizational indicators, referral system attributes, and respondent characteristics. Data were coded by Census region and state Medicaid expansion status. Bivariable and multivariable analyses were conducted using SAS. A convenience cohort (n = 559) from 44 states was examined. Nearly, half (48.7%) reported dependable M2D referral systems. In bivariate analysis, all independent variables were significant except for state Medicaid expansion status. In multivariable analysis, Census region retained significance (P = .0093). Organization type and practice issues with no shows/missed appointments continued to have significance (P < .001 and .002, respectively). Accountable care organizations were over 5 times (5.72, P = .001) more likely than RHCs to report dependable M2D referral systems. Federally qualified health clinics were slightly over 3 times more likely than RHCs to report dependable M2D referral (3.04, P < .001). No differences between RHCs and other private practices were observed. The importance of IPP continues to be promoted in the current health care environment. Our study demonstrates that, in this motivated study population, M2D referrals can work well, even in rural areas. Organization type, directionality of referral, broken appointment rates, and electronic health information management were all found to significantly impact the respondents' rating on the dependability of an M2D referral process.

Arranging blood for elective thyroid surgeries: dilemma continues in the developing world

BackgroundCross matched blood is frequently ordered based on a subjective anticipation of blood loss for a procedure. Excessive blood arrangement and wastage overburdens the blood bank in terms of work load and storage of blood, increases cost of medical care and results in injudicious use of a limited resource. The aim of this short report is to assess the current practice for arranging cross matched blood in elective thyroid surgeries by comparing cross match to blood transfused ratio.FindingsMedical records for all patients from January 2009 to December 2014 undergoing thyroid surgery were retrieved and reviewed through electronic health information management system (HIMS). A total of 91 patients were included in the study, out of which 18 (19.7%) were male and 73 (80.2%) were female. A total of 107 units of blood were arranged and only 9 were transfused. 47 patients underwent a total thyroidectomy, while 44 underwent a hemithyroidectomy. The cross match to transfusion ratio came out to be 11.88.ConclusionsRoutine arrangement of cross matched blood is not required in elective thyroid surgeries. All institutions should have a maximum blood ordering schedule planned for elective procedures, and blood products should be arranged accordingly to avoid unnecessary cross matching.

Some correlates of electronic health information management system success in nigerian teaching hospitals.

Nowadays, an electronic health information management system (EHIMS) is crucial for patient care in hospitals. This paper explores the aspects and elements that contribute to the success of EHIMS in Nigerian teaching hospitals. The study adopted a survey research design. The population of study comprised 442 health information management personnel in five teaching hospitals that had implemented EHIMS in Nigeria. A self-developed questionnaire was used as an instrument for data collection. The findings revealed that there is a positive, close relationship between all the identified factors and EHIMS’s success: technical factors (r = 0.564, P < 0.05); social factors (r = 0.616, P < 0.05); organizational factors (r = 0.621, P < 0.05); financial factors (r = 0.705, P < 0.05); and political factors (r = 0.589, P < 0.05). We conclude that consideration of all the identified factors was highly significant for the success of EHIMS in Nigerian teaching hospitals.

Designing an electronic personal health record for professional Iranian athletes.

Background:By providing sports organizations with electronic records and instruments that can be accessed at any time or place, specialized care can be offered to athletes regardless of injury location, and this makes the follow-up from first aid through to full recovery more efficient.Objectives:The aim of this study was to develop an electronic personal health record for professional Iranian athletes.Patients and Methods:First, a comparative study was carried out on the types of professional athletes’existing handheld and electronic health information management systems currently being used in Iran and leading countries in the field of sports medicine including; Australia, Canada and the United States. Then a checklist was developed containing a minimum dataset of professional athletes’ personal health records and distributed to the people involved, who consisted of 50 specialists in sports medicine and health information management, using the Delphi method. Through the use of data obtained from this survey, a basic paper model of professional athletes' personal health record was constructed and then an electronic model was created accordingly.Results:Access to information in the electronic record was through a web-based, portal system. The capabilities of this system included: access to information at any time and location, increased interaction between the medical team, comprehensive reporting and effective management of injuries, flexibility and interaction with financial, radiology and laboratory information systems.Conclusions:It is suggested that a framework should be created to promote athletes’ medical knowledge and provide the education necessary to manage their information. This would lead to improved data quality and ultimately promote the health of community athletes.

Organisational Factors Associated with Electronic Health Information Management Systems Success in two Nigerian Teaching Hospitals

Background and Purpose: Electronic Health Information Management Systems (EHIMS) are seen as crucial in public health institutions today, as they enhance quality care delivery. Efforts at implementing this system in public health institutions of developing countries have usually been fraught with failure, thus preventing it from delivering its intended benefits. One reason adduced to be responsible for failure is that more attention is given towards technological factors at the expense of organisational factors. Hence, this paper examined the relationship between organisational factors and EHIMS success in Nigerian Teaching Hospitals. Methods: A correlational survey research design was adopted, while the study’s population comprised 212 health information management (HIM) personnel in two south-western public teaching hospitals in Nigeria. Total enumeration technique was used to cover the 212 personnel who served as respondents. A self-developed instrument titled “EHIMS Success Organisational Factors” was used for data collection, while simple correlation analysis was used in analysing the collected data. Results: It was revealed that a positive relationship exists between all the identified organisational factors and EHIMS success; organisational structure (r = 0.443, p < 0.05); top management support (r = 0.613, p < 0.05); leadership style (r = 0.645, p < 0.05); users’ training (r = 0.521, p < 0.05); financial resources availability (r = 0.331, p < 0.05); and users’ involvement in system design (r = 0.633, p < 0.05). Conclusions: It was concluded that an understanding of the identified organisational factors are crucial in attaining successful implementation of EHIMS in Nigeria Teaching Hospitals. Keywords: Electronic health information management system, Organisational factors, Information system success, Teaching hospitals, Nigeria

A pilot health information management system for public health midwives serving in a remote area of Sri Lanka

We developed an electronic Health Information Management System (HIMS) for Public Health Midwives (PHMs) in Sri Lanka. We conducted a needs analysis amongst 16 PHMs, which found that they spent most of their time managing health records. The HIMS was designed so that it could accept data from the PHMs, and generate reports which could be used by the PHMs themselves as well as by their supervisors. The HIMS was trialled by a group of 16 PHMs in a remote area of the Ratnapura district of Sri Lanka. Mini-laptops with the software were distributed to the PHMs and they were given the necessary training. They started entering historical data from the registers into the system by themselves. Nearly 10,000 public health records were generated in the first three months. In a subsequent survey, the PHMs all gave positive answers indicating that they were happy with the pilot system, they would like to continue using it to enhance their service and they wanted to see it expanded across the whole of Ratnapura district. The system seems to be a practical solution for the field activities of PHMs in Sri Lanka.

Electronic Health Information Management: The Future is Ours to Embrace

Electronic Health Information Management: The Future is Ours to Embrace