Healthcare Information Technology Research Articles

Телемедицина: определение, особенности внедрения в практику, эффективность и перспективы применения в кардиологии

INTRODUCTION: Information and communication technologies in healthcare were realized in the advent of telemedicine (TM). This article presents current definitions, as well as describes the existing difficulties of terminology and classification. The main documents regulating the use of TM technologies in Russia at present are given. It is noted that the development of TM and its introduction into clinical practice is associated with a number of barriers that are associated with patients, medical professionals, as well as various technical, legal, ethical and economic problems. The presented article refers to a narrative review focused on some sources for the purpose of an unstructured description of the direction of interest. The search for literary sources was carried out in PubMed, eLibrary systems for 1995–2023 by keywords: telemedicine, telemedicine technologies, telemedicine in cardiology, telemedicine efficiency, remote control systems, telemonitoring, telemedicine in practice. The article presents the information about the role of TM in certain groups of cardiac patients, namely in patients with implanted medical devices, hypertension, chronic heart failure, high cardiovascular risk, as well as the elderlypatients and in cardiac rehabilitation. Changes in the areas of TM use are discussed, namely, attempts to use it in emergency pathology, in particular in acute coronary syndrome. CONCLUSION: Despite the absence of a common global practice and approaches to TM and the well-known barriers restraining its development, the prospects of this direction are beyond doubt. The spread of new TM technologies contributes to the improvement of providing health services system. It allows doctors to work with patients more efficiently and increases the opportunities of patients to receive expert advice. The accumulated scientific knowledge, the gradual adaptation of TM to the user’s needs, taking into account practical experience, make it possible to use this technology successfully in different groups of cardiac patients. In the future, artificial intelligence will be connected and trained to expand the opportunities for remote data analysis and the possibility of remote monitoring of patients' health, related regulatory issues will be resolved, as well as of the liability of the parties will be clearly defined. In the context of increasing demand for TM with an increase in the level of security of services provided and data protection, a global spread of advanced professional knowledge and skills is expected to improve public health.

Towards interoperability in infection control: a standard data model for microbiology

The COVID-19 pandemic has made it clear: sharing and exchanging data among research institutions is crucial in order to efficiently respond to global health threats. This can be facilitated by defining health data models based on interoperability standards. In Germany, a national effort is in progress to create common data models using international healthcare IT standards. In this context, collaborative work on a data set module for microbiology is of particular importance as the WHO has declared antimicrobial resistance one of the top global public health threats that humanity is facing. In this article, we describe how we developed a common model for microbiology data in an interdisciplinary collaborative effort and how we make use of the standard HL7 FHIR and terminologies such as SNOMED CT or LOINC to ensure syntactic and semantic interoperability. The use of international healthcare standards qualifies our data model to be adopted beyond the environment where it was first developed and used at an international level.

Utilizing technology: A cross-sectional study on ICT in healthcare in Kericho County, Kenya.

The potential for Information and Communication Technology (ICT) in healthcare is immense, revolutionizing the delivery of medical services and improving patient outcomes. ICT efficiently manages health information, facilitating electronic health records (EHRs) and streamlined communication among healthcare professionals, leading to significant changes, especially in underserved areas. This cross-sectional study took place between March and April 2023 among healthcare professionals in Kericho County, Kenya. Participants were selected using simple random sampling and completed a self-administered questionnaire. Data on the ICT status of health facilities were collected using a checklist. The qualitative component involved key informant interviews with a health record and information department officer. Collected data were entered into Excel and analysed using R software for quantitative data and thematic analysis for qualitative data. The study engaged 201 participants. Findings showed a 67.66% [95% CI=0.607, 0.741]; p-value<0.0001, uptake of ICT among healthcare workers. Those with computer training were approximately 10 times [OR = 10.867, 95% CI=3.121, 40.99] more likely to utilize ICT in service delivery than those without IT training. Operating at least one healthcare database was associated with over 2 times [OR=2.552, 95% CI=0.7475, 8.7195] higher likelihood of ICT uptake compared to those without this skill. Health facilities with eHealth platforms showed, on average, 38% higher [OR=1.386, 95% CI=0.7661, 2.223] utilization of ICT than those without. IT training for personnel is crucial, ensuring they can operate preferred health management and information systems (HMIS) within the sector. The presence of an IT department and the use of ICT for administrative purposes significantly affected the general uptake of ICT in health facilities. Additionally, infrastructure such as roads, power, and security had a significant association with ICT compliance. Improving these supportive elements will considerably enhance ICT uptake in healthcare.

Reflections on the history of interoperability in hospitals.

To discuss the origins of HL7 and its subsequent impact on interoperability in hospitals. Reconstruction of historical events from review of personal notes, interviews with key participants and review of relevant publications. The first versions of HL7 were based on the StatLAN protocol developed at the University of California, San Francisco and later commercialized by Simborg Systems Corporation. With the emergence of specialty clinical and departmental systems in the 1990s, a debate ensued between proponents of "open architecture" vs. "single vendor" systems. Although HL7 became the most widely used data-interchange protocol worldwide in healthcare, open architecture did not prevail in healthcare as it did in other industries. This is due to the unique market characteristics of the healthcare provider industry. The result today is the dominance of the healthcare IT marketplace by a small number of large vendors with relatively few options for in-depth specialty clinical systems.

Development of STEM training of specialists in the field of information technology in healthcare through educational collaboration of universities

The article discusses the issues of training STEM specialists in the implementation of joint educational programs (JEP) of medical and technical universities in the field of information technology in healthcare. A model of JEP training is proposed through the collaboration of professional standards, learning outcomes, requirements for specialists imposed by production partners, which allow to increase the efficiency of the do[1]mestic education system.

Leveraging the E-commerce footprint for the surveillance of healthcare utilization.

The utilization of healthcare services serves as a barometer for current and future health outcomes. Even in countries with modern healthcare IT infrastructure, however, fragmentation and interoperability issues hinder the (short-term) monitoring of utilization, forcing policymakers to rely on secondary data sources, such as surveys. This deficiency may be particularly problematic during public health crises, when ensuring proper and timely access to healthcare acquires special importance. We show that, in specific contexts, online pharmacies' digital footprint data may contain a strong signal of healthcare utilization. As such, online pharmacy data may enable utilization surveillance, i.e., the monitoring of short-term changes in utilization levels in the population. Our analysis takes advantage of the scenario created by the first wave of the Covid-19 pandemic in Mainland China, where the virus' spread lead to pervasive and deep reductions of healthcare service utilization. Relying on a large sample of online pharmacy transactions with full national coverage, we first detect variation that is strongly consistent with utilization reductions across geographies and over time. We then validate our claims by contrasting online pharmacy variation against credit-card transactions for medical services. Using machine learning methods, we show that incorporating online pharmacy data into the models significantly improves the accuracy of utilization surveillance estimates.

MedRSS: A blockchain-based scheme for secure storage and sharing of medical records

Due to the rapid advance of Healthcare Information Technology (HIT), the amount of medical data has increased dramatically and highly demands correct and secure storage and exchange. However, centralized medical record management systems suffer from privacy breaches, data manipulation, and insufficient shareability. In this article, we propose a blockchain-based solution for medical record data storage and sharing (MedRSS), where we apply Hyperledger fabric blockchain and encryption technology to create a secure environment for medical record data storage and sharing. Blockchain technology is used to ensure that medical records are proof of tampering, smart contracts are used to control access to data users, and cryptography is used to encrypt medical record data and digitalize sign messages. Experiments have shown that MedRSS ensures the accuracy, integrity, and security of medical records and high access throughput, outperforming existing approaches.

Integrating Information Technology in Healthcare: Recent Developments, Challenges, and Future Prospects for Urban and Regional Health

The use of technology in healthcare has become increasingly popular in recent years, with the potential to improve how healthcare is delivered, patient outcomes, and cost-effectiveness. This review paper provides an overview of how technology has been used in healthcare, particularly in cities and for personalized medicine. The paper discusses different ways technology is being used in healthcare, such as electronic health records, telemedicine, remote monitoring, medical imaging, wearable devices, and artificial intelligence. It also looks at the challenges and problems that come with using technology in healthcare, such as keeping patient data private and secure, making sure different technology systems can work together, and ensuring patients are comfortable using technology. In addition, the paper explores the potential of technology in healthcare, including improving how easily patients can get care, the quality of care they receive, and the cost of care. It also talks about how technology can help personalize care to individual patients. Finally, the paper summarizes the main points, makes recommendations for healthcare providers and policymakers, and suggests directions for future research. Overall, this review shows how technology can be used to improve healthcare, while also acknowledging the challenges that come with using technology in this way.

The Stanford Medicine data science ecosystem for clinical and translational research.

To describe the infrastructure, tools, and services developed at Stanford Medicine to maintain its data science ecosystem and research patient data repository for clinical and translational research. The data science ecosystem, dubbed the Stanford Data Science Resources (SDSR), includes infrastructure and tools to create, search, retrieve, and analyze patient data, as well as services for data deidentification, linkage, and processing to extract high-value information from healthcare IT systems. Data are made available via self-service and concierge access, on HIPAA compliant secure computing infrastructure supported by in-depth user training. The Stanford Medicine Research Data Repository (STARR) functions as the SDSR data integration point, and includes electronic medical records, clinical images, text, bedside monitoring data and HL7 messages. SDSR tools include tools for electronic phenotyping, cohort building, and a search engine for patient timelines. The SDSR supports patient data collection, reproducible research, and teaching using healthcare data, and facilitates industry collaborations and large-scale observational studies. Research patient data repositories and their underlying data science infrastructure are essential to realizing a learning health system and advancing the mission of academic medical centers. Challenges to maintaining the SDSR include ensuring sufficient financial support while providing researchers and clinicians with maximal access to data and digital infrastructure, balancing tool development with user training, and supporting the diverse needs of users. Our experience maintaining the SDSR offers a case study for academic medical centers developing data science and research informatics infrastructure.

The Role of Healthcare Information Technology (HIT) in Health Care Level of Pakistan: A Literature Review

This paper illustrates the debate and initiatives concerning the role of Healthcare Information Technology (HIT) at the Healthcare level in Pakistan. This paper reviewed the recent literature on Healthcare Information technology (HIT) to explore the role of the healthcare actors' level and healthcare delivery level. The purpose of this study is to look at the expanding role in the form of the reduced burden of diseases by the improvement of efficiency and quality of healthcare such as saving the time of patients and doctors and more affordable healthcare to overall and reduced healthcare costs, and this is all by Health Information Management System (HIMS), Telemedicine and Mobile and electronic Health in the context of Pakistan; this search identified 1025 results, 85 of which were considered on the base of abstract and conclusion but most specified article related to the objective of this paper are 45 articles in which five on the efficiency of healthcare, three on the equitable healthcare, six on the lower healthcare costs, 15 on reducing the burden of diseases, and nine on the components of Healthcare IT. The main challenges of adopting Healthcare IT and suggestions are discussed.

The Role of Cloud Computing in Modernizing Healthcare IT Infrastructure

The modernization of healthcare IT infrastructure has been aided by cloud computing, which has revolutionized the methods for storing, processing, and accessing medical data. In order to better understand how cloud computing is contributing to the advancement of healthcare technology, this study will concentrate on how it affects the handling of data, seamless integration, and system efficiency in general. Significant benefits come from the use of cloud computing in healthcare, including improved scalability and flexibility in managing enormous volumes of patient data. By leveraging storage via cloud solutions, health care providers can seamlessly multiply the information they store storage capabilities, welcoming an increasing number of medical data and diagnostic imaging. Healthcare practitioners may now access data more easily thanks to its scalability, which encourages prompt and well-informed decision-making. Furthermore, cloud computing promotes smooth communication and data interchange by facilitating interoperability across heterogeneous healthcare systems. The integration of electronic medical records, or EHRs, and other health information systems is made possible by standardized interfaces and protocols, which foster a cohesive healthcare ecosystem. This interoperability promotes a more comprehensive approach to the treatment of patients in addition to improving provider collaboration. The study also addresses the consequences of cloud computing for maintaining data security and regulatory compliance. To protect sensitive patient data, cloud service providers frequently have strong security measures in place, like encryption and access controls. Furthermore, cloud infrastructure's flexibility enables healthcare companies to easily adjust to changing regulatory requirements. A critical first step toward modernization is the incorporation of cloud computing into healthcare IT infrastructure. Cloud-based solutions' scalability, interoperability, and security not only solves immediate problems but also sets the healthcare sector up for future advancements in healthcare and information storage.

The gap between bachelor’s degree graduates in health informatics and employer needs in Saudi Arabia

BackgroundIn the field of health informatics (HI), there is a crucial gap between employers’ needs and the output of academic programmes. Although industrial organisations and government agencies recognise the importance of training and education in the development and operation of health-information systems, advancements in educational programmes have been comparatively slow in terms of investment in healthcare information technology. This study aims to determine the gap between employer demands and academic programmes in HI in Saudi Arabia.MethodsThis mixed-methods study collected both qualitative and quantitative data. A qualitative content analysis was performed to identify the role of advertised HI jobs using two sources: Google and LinkedIn. In addition, university websites were searched to determine job opportunities for graduates with a bachelor’s degree in HI. Next, a quantitative, cross-sectional self-report questionnaire was administered to validate the findings of the qualitative data. Data obtained were analysed using SPSS, N-Vivo, and Microsoft Excel.ResultsThe study’s data were obtained from four sources: Google search engine, LinkedIn, five Saudi university websites, and 127 HI experts. The results show a discrepancy between academic programmes’ outputs and employer recruitment needs. In addition, the results reveal a preference for post-graduate degrees, either a master’s or PhD degree, with a bachelor’s degree in a health or medical discipline.ConclusionsEmployers tend to prefer applicants with a bachelor’s degree in computer science or information technology over those with a degree in HI. Academic programmes should incorporate more practical applications and provide students with a thorough understanding of the healthcare industry to better equip them as efficient future HI professionals.

Differential Perceptions of What Constitutes a Medical Error Associated with Electronic Medical Records.

Perceptions of errors associated with healthcare information technology (HIT) often depend on the context and position of the viewer. HIT vendors posit very different causes of errors than clinicians, implementation teams, or IT staff. Even within the same hospital, members of departments and services often implicate other departments. Organizations may attribute errors to external care partners that refer patients, such as nursing homes or outside clinics. Also, the various clinical roles within an organization (e.g., physicians, nurses, pharmacists) can conceptualize errors and their root causes differently. Overarching all these perceptual factors, the definitions, mechanisms, and incidence of HIT-related errors are remarkably conflictual. There is neither a universal standard for defining or counting these errors. This paper attempts to enumerate and clarify the issues related to differential perceptions of medical errors associated with HIT. It then suggests solutions.

In support of interoperability: A laboratory perspective.

Healthcare in the United States has become increasingly digital since the passage of the HITECH Act in 2009. As a result, there is a growing need to optimize healthcare IT to allow for the interoperable exchange of data. As a result, the Office of the National Coordinator for Health IT has implemented their Final Rule for the 21st Century Cures Act. This requires certified health IT systems to use modernized messaging standards for the safe and secure exchange of data within health information networks and also requires the use of terminology standards including LOINC, SNOMED CT, and UCUM for coding clinical and laboratory data. Given the critical importance of laboratory results in the delivery of healthcare, laboratorians must become familiar with these principles of interoperability. Their clinical laboratory expertise is needed to appropriately structure and code test results to safeguard against improper aggregation or misinterpretation by downstream users and systems.

Strengthening and promoting digital health practice: results from a Global Digital Health Partnership's survey.

The capacity to promote and disseminate the best evidence-based practices in terms of digital health innovations and technologies represents an important goal for countries and governments. To support the digital health maturity across countries the Global Digital Health Partnership (GDHP) was established in 2019. The mission of the GDHP is to facilitate global collaboration and knowledge-sharing in the design of digital health services, through the administration of surveys and white papers. The scope of this study is to critically analyze and discuss results from the Evidence and Evaluation GDHP Work Stream's survey, understand how governments and countries intend to address main obstacles to the digital health implementation, identify their strategies for a communication of effective digital health services, and promote the sharing of international based best practices on digital health. This survey followed a cross-sectional study approach. A multiple-choice questionnaire was designed to gather data. Choices were extracted from research publications retrieved through a rapid review. Out of 29 countries receiving the survey, 10 returned it. On a scale from 1 to 5, eHealth systems/platforms (mean = 3.56) were indicated as the most important tool for centralized infrastructure to collect information on digital health, while primary care (mean = 4.0) represented the most voted item for healthcare services to collect information on digital health. Seven Countries out of 10 identified lack of organization, skepticism of clinicians, and accessibility of the population as a barriers to adopt digital health implementation, resulting to be the most voted items. Finally, the most endorsed priorities in digital health for Countries were the adoption of data-driven approaches (6 Countries), and telehealth (5 Countries). This survey highlighted the main tools and obstacles for countries to promote the implementation of evidence-based digital health innovations. Identifying strategies that would communicate the value of health care information technology to healthcare professionals are particularly imperative. Effective communication programs for clinicians and the general population in addition to improved digital health literacy (both for clinicians and citizens) will be the key for the real implementation of future digital health technologies.

Hacking Acute Care: A Qualitative Study on the Health Care Impacts of Ransomware Attacks Against Hospitals

Cyberattacks are an increasing threat to health care institutions which potentially impair patient outcomes. Current research is limited and focuses mainly on the technical consequences, whereas little is known about health care staff experiences and the effect on emergency care. This study aimed to explore the acute care effect of several large ransomware attacks against hospitals that occurred in Europe and the United States between 2017 and2022. This interview-based qualitative study assessed the experiences of emergency health care professionals and information technology (IT) staff and investigated the challenges during the acute and recovery phase of hospital ransomware attacks. The semistructured interview guideline was based on relevant literature and cybersecurity expert consultation. Transcripts were anonymized, and traceable information regarding participants and/or their organizations was removed for privacy purposes. Nine participants were interviewed, including emergency health care providers and IT-focused staff. Five themes were constructed from the data: effects and challenges regarding patient care continuity, challenges during the recovery process, personal effect on health care staff, preparedness and lessons identified, and future recommendations. According to the participants of this qualitative study, ransomware attacks have a significant effect on emergency department workflow, acute care delivery, and the personal well-being of health care providers. Preparedness for such incidents is limited, and many challenges are encountered during the acute and recovery phase of attacks. Although there was profound hesitancy among hospitals to participate in this study, the limited number of participants provided valuable information that can be used to develop response strategies for hospital ransomware attacks.

Building resilient hospital information technology services through organizational learning: Lessons in CIO leadership during an international systemic crisis in the United States and Abu Dhabi, United Arab Emirates

BackgroundThe COVID-19 pandemic was an international systemic crisis which required an unprecedented response to quickly drive the digital transformation of hospitals and health care systems to support high quality health care while adhering to contagion management protocols. ObjectiveTo identify and assess the best practices during the COVID-19 pandemic by Chief Information Officers (CIOs) about how to build resilient healthcare IT (HIT) to improve pandemic preparedness and response across global settings and to develop recommendations for future pandemics. MethodsWe conducted a qualitative, interview-based study to sample CIOs in hospitals. We interviewed 16 CIOs from hospitals and health systems in the United States and Abu Dhabi, United Arab Emirates. We used in-depth interviews to capture their perspectives of the preparedness of hospitals’ information technology departments for the pandemic and how they lead their IT department out of the pandemic. ResultsResults showed that healthcare CIOs were ambidextrous IT leaders who built resilient HIT by rapidly improving existing digital business practices and creating innovative IT solutions. Ambidextrous IT leadership involved exploiting existing IT resources as well as exploring and innovating for continuous growth. IT resiliency focused on four inter-related capabilities: ambidextrous leadership, governance, innovation and learning, and HIT infrastructure. ConclusionsWe propose conceptual frameworks to guide the development of healthcare IT resilience and highlight the importance of organizational learning as an integral component of HIT resiliency.

Can the National Health Policy 2017 Strengthen the National Health System and Improve the Health of the Indian Populace?

The union cabinet approved the National Health Policy (NHP) 2017 on 15 March 2017. After its initial draft stage, seeking opinions from different stakeholders for nearly 34 months, the NHP 2017 came to the public domain with its final version. The main objective of this version of the NHP is to implement the proposed National Health Assurance Plan, which has been one of the agendas of the National Democratic Alliance (NDA) government for the healthcare of the people. The main objective of this article is to critically appraise and discuss the scopes and limitations in accomplishing the targets set in the policy document. A critique of the targets has also been discussed, considering the historical evidence and experiences of achieving the same. In the end, suggestions and recommendations have also been suggested for improving the health system regarding NHP 2017. The article critically analyses NHP 2017 based on secondary and grey literature. Evidence from secondary literature has been juxtaposed to compare and contrast the difficulty in implementing the policy. Literature is obtained from electronically accessible search and indexing portals, such as Google, Google Scholar, Web of Sciences, Embase, PubMed, and PubMed Central by using the keywords like health policy, impact of health policy, human resources in health, health care information technology, hospitals, pharmaceuticals and medical devices, health insurance and public health. Considering the implementation challenges of the previous two NHPs, the current NHP 2017 should be relevant to the grassroots level nuances and should address not only the healthcare needs but also the human development indicators.

Enhancing Knowledge Management in Healthcare: An Embedding Fusion Approach to Business Rule Representation

Enterprise Decision Management systems are vital for delivering efficient healthcare services. However, the ever-changing clinical terminology creates complex business rules, making healthcare IT systems difficult to maintain. In this study, we present an embedding fusion technique using unsupervised Natural Language Processing (NLP) to represent business rules as semantic vectors by incorporating multiple text data sources for each rule. We apply this method to a dental insurance administration case study and find that our approach is over 200 times more likely to identify redundant rule pairs compared to random pairs. This case study suggests that an embedding-based technique can significantly improve knowledge management efficiency in healthcare IT systems.

A secure lightweight fuzzy embedder based user authentication scheme for internet of medical things applications

The Internet of Medical Things (IoMT) is a network of medical devices, hardware infrastructure, and software that allows healthcare information technology to be communicated over the web. The IoMT sensors communicate medical data to server for the quick diagnosis. As, it handles private and confidential information of a user, security is the primary objective. The existing IoT authentication schemes either using two-factor(Username, password) or multi-factor (username, password, biometric) to authenticate a user. Typically the structural characteristics-based biometric trait like Face, Iris, Palm print or finger print is used as a additional factor. There are chances that these biometrics can be fabricated. Thus, these structural biometrics based authentication schemes are fail to provide privacy, security, authenticity, and integrity. The biodynamic-based bioacoustics signals are gained attention in the era of human-computer interactions to authenticate a user as it is a unique feature to each user. So, we use a frequency domain based bio-acoustics as a biometric input. Thus, this work propose a Secure Lightweight Bioacoustics based User Authentication Scheme using fuzzy embedder for the Internet of Medical Things applications. Also, the IoT sensors tends to join and leave the network dynamically, the proposed scheme adopts chinese remainder technique for generate a group secret key to protect the network from the attacks of former sensor nodes. The proposed scheme’s security is validated using the formal verification tool AVISPA(Automated Validation of Internet Security Protocols and Applications). The system’s performance is measured by comparing the proposed scheme to existing systems in terms of security features, computation and communication costs. It demonstrates that the proposed system outperforms existing systems.