Health Informatics Applications Research Articles

Análisis de las preferencias de los profesionales sanitarios respecto a la prescripción electrónica de tratamientos farmacológicos en pacientes hospitalizados

Objectiveto evaluate health personnel perceptions about medical order entry systems concerning the effect on workflow, medication errors risk and assessment of its potential advantages. Material and methodsA cross-section opinion interview was conducted in a tertiary care hospital. Questionnaire consisted of three sections: perception of its effect on workflow, influence on medication error risk and assessment of potential advantages. We also asked them to assess drawbacks and provide suggestions about this prescription system. Results76 health professionals were interviewed (58 physicians, 9 pharmacists and 9 nurses). They were satisfied mainly due to decrease the workload (85.5%; IC 95%: 75.58-92.55). They thought that the main characteristics that contribute to reduce medication errors are clinical decision supports related to predefined aspects which the program provided by default. Among potential benefits of medical order entry systems, legibility and warnings triggered by the program (98.7%; IC 95%: 92.90-99.97 and 97,4%; IC 95%: 90.81-99.68 respectively) were the most valuable. High technology dependence, IT failures and lack of infrastructure and medication therapy discontinuities at times of transition between different hospitals’ units were the main drawbacks considered. The most repeated suggestion was related to the improvement of links between other health informatics applications used in the hospital. Conclusionhealth personnel were highly satisfied with the CPOE system, which is considered to be effective and safe. Technology dependence and IT failures were the main disadvantages reported. According to them, a greater coordination and unification of all software applications available in the hospital would be desirable.

Abstract TP317: Mobile Technology Profile of Stroke Survivors and Caregivers: Preliminary Results from a National Survey

Background: Recent estimates are that approximately 110 million Americans have access to nearly 14,000 health-related apps. There is a paucity in applications specific for stroke, either survivors or caregivers. Objective: Qualitative survey of stroke survivors and caregivers’ needs, attitudes, knowledge, and behaviors concerning mobile technology (m-TECH) was assessed through an online medium. Methods: National Stroke Association (NSA) elicited responses from a random, national sample of 601 stroke survivors and caregivers. The 25-question survey asked about how stroke survivors and caregivers track their health information, use smartphones and available health-related applications, and their perceived needs and preferences for a potential smartphone application. Data were collected on demographics, health tracking behavior, smartphone and mobile health application use, and interest in health management applications. Responses were collected through open source online survey application, LimeSurvey. Results: Thirty-five (6%) individuals (range 18-91+ years; 55% female) completed the survey, evenly split between: stroke survivors and caregivers; 41% completed some college. The majority of respondents (73%) tracked their health information to manage risk factors to prevent stroke: medication tracking (82%), monitoring blood pressure and cholesterol (77%), and managing medical appointments (73%). The greatest barrier to tracking health information was forgetfulness (41%). Half owned smartphones, with 27% Android users and 14% iPhone users, with almost half (45%) reporting to have downloaded applications on their smartphones that they used (41%), including multiple times a day (32%). Additionally, 23% of the smartphone users reported using their phones to track health information. Majority (60%) of respondents expressed interest in smartphone apps that can help managing health information and half (50%) were interested in helping with the application development. Conclusions: Recognizing concern over generalizability, these preliminary results suggest a clear need for patient-centered mobile health applications in personal health management tailored specifically for stroke survivors and caregivers.

Assistive environments for the disabled and the senior citizens: theme issue of PETRA 2010 and 2011 conferences

The introduction of pervasive and ubiquitous systems into everyday life pushes this technology to become increasingly embedded in artifacts and environments trying to address an important social and health care issue: as the world’s population ages, there is growing need for technologies to assist with the in-home care of the elderly and people with Alzheimer’s, Parkinson’s and numerous types of chronic disabilities or traumas. The quality of people’s living environments is particularly important in an increasingly crowded and complex world in which inclusiveness and connectivity with the rest of the world is critical. Furthermore, enabling such persons remain productive and active is of high socioeconomic importance to every country’s workforce or health care system. Assistive environments is a field that addresses the fact that, as people grow older or become disabled, they increasingly rely on computer technology to be able to live in and function in their homes [1–3]. Finally, assistive environments is a field that pushes innovation and interdisciplinary collaboration forward, catalyzes the union of computation with the development of new materials (e.g., sensors) and devices (e.g., assistive robots), new or improved drugs and drug administration, new methods and software for rehabilitation, physical/occupational therapy, new materials for safety or disorder monitoring (e.g., sleep disorders connected with epilepsy or depression), new algorithms for mental health and emotion monitoring (e.g., through facial expressions or speech), new types of virtual life coaches (e.g., avatars to promote exergaming) and many other innovations. This special issue comes after the successful organization of the 3rd and 4th International Conferences on ‘‘PErvasive Technologies Related to Assistive Environments—PETRA 2010 and 2011,’’ which were held in Corfu, Greece and Herakleion, Crete, Greece, respectively (http://www.petrae.org/). Both conferences received funding from the US National Science Foundation as well as support from the Hellenic National Center for Scientific Research—Demokritos and many other organizations. The focus of this special issue is how and what new technological innovations can assist and empower an elder or disabled human in everyday life. What technologies can assist specific health care needs, at home and at work, in a person’s everyday routine by using sensors, databases, personal area networks, ubiquitous connectivity, distributed intelligence and adaptive, easy to use interfaces and interactions. This special issue focuses on research involving the design, development, evaluation and use of emerging pervasive technologies for assistive environments for the disabled and the senior citizen, taking also into account the target audience of the PUC journal. The realization of pervasive health information applications through mobile devices introduces several challenges, such as (1) infrastructure for unified and ubiquitous access or medical data storage and management [4, 5], I. Maglogiannis (&) Department of Computer Science and Biomedical Informatics, University of Central Greece, Papasiopoulou 2-4, 35100 Lamia, Greece e-mail: imaglo@gmail.com; imaglo@ucg.gr

Health informatics standardization and RHIS construction patterns

This report mainly introduces the importance of health informatics standardization and the current international and Chinese research status, analyzes the developing trend and prospects of health informatics standardization, discusses the RHIS (regional health information system) of two kinds of construction Patterns. On this basis, this report points out the difficulties of health informatics standardization implementation and application, and some corresponding resolving measures and advice.

Critical Advances in Bridging Personal Health Informatics and Clinical Informatics

To provide a survey over significant developments in the area of linking personal health informatics and clinical informatics, to give insights into critical advances and to discuss open problems and opportunities in this area. A scoping review over the literature published in scientific journals and relevant conference proceedings in the intersection between personal health informatics and clinical informatics over the years 2010 and 2011 was performed. The publications analyzed are related to two main topics, namely "Sharing information and collaborating through personal health records, portals and social networks" and "Integration of personal health systems with clinical information systems". For the first topic, results are presented according to five different themes: "Patient expectations and attitudes", "Real use experiences", "Changes for care providers", "Barriers to adoption" and "Proposed technical infrastructures". For the second topic, two different themes were found, namely "Technical architectures and interoperability" and "Security, safety and privacy issues". Results show a number of gaps between the information needs of patients and the information care provider organizations provide to them as well as the lack of a trusted technical, ethical and regulatory framework regarding information sharing. Despite recent developments in the areas of personal health informatics and clinical informatics both fields have diverging needs. To support both clinical work processes and empower patients to effectively handle self-care, a number of issues remain unsolved. Open issues include privacy and confidentiality, including trusted sharing of health information and building collaborative environments between patients, their families and care providers. There are further challenges to meet around health and technology literacy as well as to overcome structural and organizational barriers. Frameworks for evaluating personal health informatics applications and pervasive health technology are needed to build up an evidence basis.

Knowledge Representation and Management: Towards Patient Health Self-management

To summarize excellent current research in the field of knowledge representation and management (KRM). A synopsis of the articles selected for the IMIA Yearbook 2012 is provided and an attempt to highlight the current trends in the field of health management is sketched. Among the five selected papers, two confirm the benefit of exploiting open-source language toolkits for the automatic extraction of medical concepts, assertions and/or relationships from clinical texts. One paper aims at exploiting domain-specific terminologies to improve the parsing of biomedical noun phrases, and another one aims at discovering rare diseases associations embedded into disparate textual sources. Finally, the last paper describes a collaborative search approach integrated into a homegrown EHR search engine. This selected set of papers confirms that natural language processing, as well as knowledge extraction, discovering and retrieval, are still active and fruitful research fields. Although these papers are not directly focusing on personal health informatics applications,, important features are highlighted and tailored to fit the requirements of patient health self-management. Delivering timely, friendly and secure access to functional, accurate, up-to-date and sustainable personal health records is a significant challenging task for supporting self-managed healthcare.

Fuzzy modelling and efficiency in health care systems

American Medical Institute reports that each year, because of the medical error, minimum fifty thousand people are dead. For a safety and quality medical system, it is important that information systems are used in health care systems. Health information applications help us to reduce the human error and to support patient care systems. Recently, it is reported that medical information systems applications have also some negative effect on all medical integral elements. The cost of health care information systems is about 4.6% of the total cost. In this paper, it is tried a risk determination model according to principles of fuzzy logic. The improvement of health care systems has become a very popular topic in Turkey recent years. Using necessary information system; it became possible to care patients in a safer way. However, using the necessary HIS tools to manage of administrative and clinical processes at hospitals became more important than before. For example; clinical work flows and communication among pharmacists, nurses and physicians are still not enough investigated. We use fuzzy modeling as a research strategy and developed sum fuzzy membership functions to minimize human error. In application in Turkey the results are significantly related with each other. Besides, the sign differences in health care information systems strongly effects of risk magnitude. The obtained results are discussed and some comments are added.

An Introduction to Consumer Health Apps for the iPhone

Access to health care information increased substantially with the commercial arrival of the Internet in the 1990s; consumers of health information had access to a tremendous amount of information at their fingertips. With the launch of the iPhone in 2007, information became accessible and portable. This article will examine the early usage of health information applications, or “apps,” and provide an overview of several apps for the iPhone. Numerous areas of future research that can be applied to the emerging arena of consumer health apps will also be identified.

Reporting qualitative research in health informatics: REQ-HI recommendations.

To develop a set of recommendations for authors of qualitative studies in the field of health informatics, we conducted an extensive literature search and also manually checked major journals in the field of biomedical informatics and qualitative research looking for papers, checklists, and guidelines pertaining to assessing and reporting of qualitative studies. We synthesized the found criteria to develop an initial set of reporting recommendations that are particularly relevant to qualitative studies of health information technology systems. This paper presents a preliminary version of these recommendations. We are planning to refine and revise this version using comments and suggestions of experts in evaluation of health informatics applications and publish a detailed set of recommendations.

Computer-Assisted Update of a Consumer Health Vocabulary Through Mining of Social Network Data

BackgroundConsumer health vocabularies (CHVs) have been developed to aid consumer health informatics applications. This purpose is best served if the vocabulary evolves with consumers’ language.ObjectiveOur objective was to create a computer assisted update (CAU) system that works with live corpora to identify new candidate terms for inclusion in the open access and collaborative (OAC) CHV.MethodsThe CAU system consisted of three main parts: a Web crawler and an HTML parser, a candidate term filter that utilizes natural language processing tools including term recognition methods, and a human review interface. In evaluation, the CAU system was applied to the health-related social network website PatientsLikeMe.com. The system’s utility was assessed by comparing the candidate term list it generated to a list of valid terms hand extracted from the text of the crawled webpages.ResultsThe CAU system identified 88,994 unique terms 1- to 7-grams (“n-grams” are n consecutive words within a sentence) in 300 crawled PatientsLikeMe.com webpages. The manual review of the crawled webpages identified 651 valid terms not yet included in the OAC CHV or the Unified Medical Language System (UMLS) Metathesaurus, a collection of vocabularies amalgamated to form an ontology of medical terms, (ie, 1 valid term per 136.7 candidate n-grams). The term filter selected 774 candidate terms, of which 237 were valid terms, that is, 1 valid term among every 3 or 4 candidates reviewed.ConclusionThe CAU system is effective for generating a list of candidate terms for human review during CHV development.

Healthcare Providers’ Perceptions towards Health Information Applications at King Abdul-Aziz Medical City, Saudi Arabia

The purpose of this study was to assess the perceptions of healthcare providers towards health information technology applications in King Abdul-Aziz Medical City (KAMC) in terms of benefits, barriers, and motivation to use these applications. Data Collection: The study population consists of all healthcare providers working at KAMC. A sample size of 623 was drawn from a population of 7493 healthcare providers using convenience random sampling method. Of 623 questionnaires distributed, 377 were returned, giving a response rate of 60.5 percent. Measurement A self-administered questionnaire was developed based on extended literature review. The questionnaire comprised 25 statements measuring benefits, barriers, and motivation to use health information applications to be responded on a five-point Likert-scale. In addition, the questionnaire included questions on demographic and organizational variables. Results: The results show that the majority of healthcare providers had good knowledge and skills in information technology, as most of them use KAMC health information applications regularly and/or had training courses in the field. The results indicated that training has a significant positive effect on health providers' IT knowledge and skills. The majority of healthcare providers perceived that the information technology applications in KAMC are valuable and beneficial to both patients and KAMC. However, the healthcare providers were split over the barriers to HIT use in KAMC. As for drivers, the results showed that healthcare providers generally would be motivated to use IT applications in KAMC by provision of new applications and training, contribution in change hospital's work procedures, and provision of technical support. Finally, the results showed the perceptions of healthcare providers on benefits, barriers and motives were influenced by gender, occupation and training. However, the effect of these variables on healthcare providers towards benefits, barriers and motives of IT use were inconsistent. Conclusion: Despite the perceived benefits and motives of health information applications, there were many barriers identified by healthcare providers. These were insufficient number of computers, frequent system down, and the use of computerized systems is time consuming. Furthermore, there were significant differences in the perceptions of healthcare providers towards benefits, barriers, and motives to health information technology with respect gender, occupation, and training.

Project HealthDesign: Rethinking the power and potential of personal health records

Project HealthDesign, a multi-year, multi-site project sponsored by the Robert Wood Johnson Foundation with additional support from the California HealthCare Foundation, is designed to stimulate innovation in personal health records (PHRs). Project HealthDesign teams employed user-centered design processes to create designs and prototypes of computer-based applications to support and enhance human health for a wide range of patients, from children with chronic health conditions to elders transitioning from hospital to home. A program design philosophy encouraged designers to envision PHRs as a suite of personal health information management tools, or applications, separate from, but drawing upon, personal health data from a variety of sources. In addition to information contained in one’s medical record, these personal health data included patient-supplied clinical parameters such as blood glucose and daily weights; as well as patient-generated observations of daily living (ODLs) – the unique, idiosyncratic cues, such as sleep adequacy or confidence in self care, that inform patients about their abilities to manage health challenges and take healthy action. A common technical platform provided infrastructure services such as data standards and identity-management protocols, and helped to demonstrate a scalable, efficient approach to user-centered design of personal health information management systems. The program’s ethical, legal and social issues consultancy identified challenges to acceleration of action-focused PHRs: personal control of privacy choices, management of privacy in home conditions, and rebalancing power structures in shared decision making.

Handbook of Research on Advances in Health Informatics and Electronic Healthcare Applications: Global Adoption and Impact of Information Communication Technologies

Handbook of Research on Advances in Health Informatics and Electronic Healthcare Applications: Global Adoption and Impact of Information Communication Technologies

Consumer health informatics and interactive visual learning tools for health

Consumer health informatics is a part of medical informatics that has as first priority to analyse the interaction between Information Technology (IT) and health consumers. Consumer health informatics applications are designed to interact directly with the customer with or without the essential presence of healthcare. This field of virtual informatics tended to be developed by people other than clinical professions. The purpose of this paper is to provide a brief overview of best practices and methods for customers' health information and to describe the best interactive visual learning tools for health education. Consumer health informatics is an interdisciplinary field much as other informatics fields. Some disciplines that may find consumer health informatics valuable include public health, nursing, health education and communication sciences. It is important that organisations such as medical universities and governmental agencies to provide trustworthy high-quality health information on internet and work harder and create practical health education tools.

STARE-HI -Statement on Reporting of Evaluation Studies in Health Informatics

Development of guidelines for publication of evaluation studies of Health Informatics applications. An initial list of issues to be addressed in reports on evaluation studies was drafted based on experiences as editors and reviewers and as authors of systematic reviews , taking into account guidelines for reporting of medical research. This list has been discussed in several rounds by an increasing number of experts in Health Informatics evaluation during conferences and by using e-mail. A set of STARE-HI principles to be addressed in papers describing evaluations of Health Informatics interventions is presented. These principles include formulation of title and abstract, of introduction (e.g. scientific background, study objectives), study context (e.g. organizational setting, system details), methods (e.g. study design, outcome measures), results (e.g. study findings, unexpected observations) and discussion and conclusion. A comprehensive list of principles relevant for properly describing Health Informatics evaluations has been developed. When manuscripts submitted to Health Informatics journals and general medical journals adhere to these aspects, readers will be better positioned to place the studies in a proper context and judge their validity and generalisability. STARE-HI may also be used for study planning and hence positively influence the quality of evaluation studies in Health Informatics. We believe that better publication of (both quantitative and qualitative) evaluation studies is an important step toward the vision of evidence-based Health Informatics. This study is based on experiences from editors, reviewers, authors of systematic reviews and readers of the scientific literature. The applicability of the principles has not been evaluated in real practice. Only when authors start to use these principles for reporting, shortcomings in the principles will emerge.

Public Health Informatics and the H1N1 Pandemic

On June 11th 2009, Dr. Margaret Chan, Director-General of the World Health Organization (WHO), announced that the Influenza alert level was being raised from a Phase 5 to Phase 6 indicating the start of the 2009 Pandemic. The pandemic resulted from a previously uncirculated strain of H1N1 Influenza which spread rapidly in the spring of 2009. The second wave of the pandemic began as schools reopened in the late summer. At the time of the writing of this commentary, H1N1 was widely spread in 48 states and Canada. Due to the intensive surveillance and preparedness activities surrounding a rapidly spreading avian H5N1 influenza, the WHO and the Centers for Disease Control and Prevention, were able to closely monitor the progression of the H1N1 strain in the human population and initiate an accelerated vaccination program. This heightened activity comes at a time of reduced budgets for state and local health departments who have primary responsibility for monitoring and containment within their jurisdictions. As resources become more limited, public health workers are forced to focus their attention on the most urgent priorities. In order to effectively multi-task, public health must leverage new technologies to get more done with existing resources. Public health informatics is an emerging field that has the potential to immediately support the ten essential public health services. Automated case specific disease monitoring applications can now collect, analyze and present to the user information that would have taken days to assemble only a few years ago. Applications such as ESSENCE, RODS, and BioSense have been able to monitor spread of H1N1 at state, local, and national levels. The Internet has become an educational tool for informing the population on the latest research to maintain and improve health. The websites of local health departments, CDC, WHO, WebMD, Google and many others have all seen increased activity as primary caregivers seek information on how to protect their family members from H1N1. Emerging knowledge repositories showcased at national conferences have demonstrated the ability to transparently provide public health alerts to clinicians during patient encounters. Information is provided to support disease management while enhancing real-time monitoring. The Internet provides a secure collaborative environment to support public health monitoring across jurisdictional boundaries. The DiSTRIBuTE project creates a national view of H1N1 trends from data provided by public health agencies across the country that have the desire to collaborate with their counterparts in other jurisdictions. These are just a few public health informatics applications that support H1N1 containment. As the field of public health informatics expands, its researchers and developers must keep in mind the goal of translating their achievements into open environment so that their informatics products can be made available to public health practitioners when they are needed. Traditionally, informatics tools are presented to the community at conferences and through journal articles. Local public health funding limitations may restrict travel at conferences or membership in societies that publish articles in their journals. The Online Journal of Public Health Informatics (OJPHI) provides an open access vehicle that supports the presentation of the latest open source informatics tools to the public health community to support their translation to practice. As an open access communications vehicle to public health, articles published in OJPHI could provide knowledge of an open source informatics tools to help public health manage the next emerging health risk.

Government Not Doing Enough to Ensure Medical-Record Privacy

Back to table of contents Previous article Next article Professional NewsFull AccessGovernment Not Doing Enough to Ensure Medical-Record PrivacyMark MoranMark MoranSearch for more papers by this authorPublished Online:7 Nov 2008https://doi.org/10.1176/pn.43.21.0010aThe federal government needs to do more to ensure privacy and confidentiality in any national electronic health information network that is developed.In particular, the Office of the National Coordinator for Health Information Technology needs to develop a process for assessing the myriad privacy concerns of different stakeholders and for determining how all of those concerns will be addressed in an overall strategy for ensuring privacy and confidentiality, according to a report by the Government Accountability Office (GAO) released in September.The Department of Health and Human Services' (HHS) “privacy approach does not include a defined process for assessing and prioritizing the many privacy-related initiatives to ensure that key privacy principles and challenges will be fully and adequately addressed,” according to the report. “As a result, stakeholders may lack the overall policies and guidance needed to assist them in their efforts to ensure that privacy protection measures are consistently built into health information technology programs and applications. Moreover, the department may miss an opportunity to establish the high degree of public confidence and trust needed to help ensure the success of a nationwide health information network.”In January 2007, the GAO issued a report on protecting the privacy of electronic health information that asked HHS to identify milestones and assign responsibility for integrating the outcomes of its privacy-related initiatives, ensure that key privacy principles are addressed, and address key challenges associated with the nationwide exchange of health information.The new GAO report noted that HHS has undertaken some important steps. They include the following:The Healthcare Information Technology Standards Panel defined standards for implementing security features in systems that process personal health information.The panel is a body of the American National Standards Institute. According to the institute's Web site, “The mission of the Healthcare Information Technology Standards Panel is to serve as a cooperative partnership between the public and private sectors for the purpose of achieving a widely accepted and useful set of standards specifically to enable and support widespread interoperability among health care software applications, as they will interact in a local, regional, and national health information network for the United States.”The Certification Commission for Healthcare Information Technology defined certification criteria that included privacy protections for both outpatient and inpatient electronic health records. The Certification Commission Healthcare Information Technology is a recognized certification body for electronic health records and their networks and an independent, voluntary, private-sector initiative.Initiatives aimed at the state level have convened stakeholders to identify and propose solutions for addressing challenges faced by health information exchange organizations in protecting the privacy of electronic health information.In addition, the secretary of HHS released a federal health information technology strategic plan in June that includes privacy and security objectives, along with strategies and target dates for achieving them.But HHS needs to do more, the GAO said.“In particular, the department has not defined a process for ensuring that all privacy principles and challenges will be fully and adequately addressed,” the GAO stated. “This process would include, for example, steps for ensuring that all stakeholders' contributions to defining privacy-related activities are appropriately considered and that individual inputs to the privacy framework will be effectively assessed and prioritized to achieve comprehensive coverage of all key privacy principles and challenges.“Such a process is important given the large number and variety of activities being undertaken and the many stakeholders contributing to the health information technology initiatives. In particular, the contributing activities involve a wide variety of stakeholders, including federal, state, and private-sector entities.”“HHS Has Taken Important Steps to Address Privacy Principles and Challenges, Although More Work Remains” is posted at<www.gao.gov/new.items/d081138.pdf>. Information about the Certification Commission for Healthcare Information Technology is posted at<www.cchit.org>.▪ ISSUES NewArchived

Development of Grid-like Applications for Public Health Using Web 2.0 Mashup Techniques

Development of public health informatics applications often requires the integration of multiple data sources. This process can be challenging due to issues such as different file formats, schemas, naming systems, and having to scrape the content of web pages. A potential solution to these system development challenges is the use of Web 2.0 technologies. In general, Web 2.0 technologies are new internet services that encourage and value information sharing and collaboration among individuals. In this case report, we describe the development and use of Web 2.0 technologies including Yahoo! Pipes within a public health application that integrates animal, human, and temperature data to assess the risk of West Nile Virus (WNV) outbreaks.The results of development and testing suggest that while Web 2.0 applications are reasonable environments for rapid prototyping, they are not mature enough for large-scale public health data applications. The application, in fact a “systems of systems,” often failed due to varied timeouts for application response across web sites and services, internal caching errors, and software added to web sites by administrators to manage the load on their servers. In spite of these concerns, the results of this study demonstrate the potential value of grid computing and Web 2.0 approaches in public health informatics.

STARE-HI—Statement on reporting of evaluation studies in Health Informatics

Objective Development of guidelines for publication of evaluation studies of Health Informatics applications. Methods An initial list of issues to be addressed in reports on evaluation studies was drafted based on experiences as editors and reviewers of journals in Health Informatics and as authors of systematic reviews of Health Informatics studies, taking into account guidelines for reporting of medical research. This list has been discussed in several rounds by an increasing number of experts in Health Informatics evaluation during conferences and by using e-mail and has been put up for comments on the web. Results A set of STARE-HI principles to be addressed in papers describing evaluations of Health Informatics interventions is presented. These principles include formulation of title and abstract, of introduction (e.g. scientific background, study objectives), study context (e.g. organizational setting, system details), methods (e.g. study design, outcome measures), results (e.g. study findings, unexpected observations) and discussion and conclusion of an IT evaluation paper. Conclusion A comprehensive list of principles relevant for properly describing Health Informatics evaluations has been developed. When manuscripts submitted to Health Informatics journals and general medical journals adhere to these aspects, readers will be better positioned to place the studies in a proper context and judge their validity and generalisability. It will also be possible to judge better whether papers will fit in the scope of meta-analyses of Health Informatics interventions. STARE-HI may also be used for study planning and hence positively influence the quality of evaluation studies in Health Informatics. We believe that better publication of both quantitative and qualitative evaluation studies is an important step toward the vision of evidence-based Health Informatics. Limitations This study is based on experiences from editors, reviewers, authors of systematic reviews and readers of the scientific literature. The applicability of the principles has not been evaluated in real practice. Only when authors start to use these principles for reporting, shortcomings in the principles will emerge.

The Informatics Opportunities at the Intersection of Patient Safety and Clinical Informatics

Health care providers have a basic responsibility to protect patients from accidental harm. At the institutional level, creating safe health care organizations necessitates a systematic approach. Effective use of informatics to enhance safety requires the establishment and use of standards for concept definitions and for data exchange, development of acceptable models for knowledge representation, incentives for adoption of electronic health records, support for adverse event detection and reporting, and greater investment in research at the intersection of informatics and patient safety. Leading organizations have demonstrated that health care informatics approaches can improve safety. Nevertheless, significant obstacles today limit optimal application of health informatics to safety within most provider environments. The authors offer a series of recommendations for addressing these challenges.