Healthcare Information Technology Research Articles

Association between type 2 diabetes and cancer incidence in China: data in hospitalized patients from 2006 to 2013.

BackgroundEvidence of a role for type 2 diabetes in overall cancer risk is limited in ethnic Chinese populations. We therefore investigated whether there is an association between diabetes and cancer incidence.MethodsAll type 2 diabetes and cancer hospitalized patients from the First Affiliated Hospital of Nanjing Medical University between 2006.01 and 2013.12 were eligible for the study. Our research used healthcare information technology and statistical methods to analyze the clinical data of hospitalized patients and explored the relationship between diabetes and cancer. Participants with fasting glucose ≥126 mg/dL, or taking hypoglycemic medications, were classed as having type 2 diabetes. Cancer incidence was established through regular follow-up interviews and medical records. Data were entered into Excel and a database was set up with ACCESS software. Clinical information such as demographics like gender, age, occupation, marriage, insurance and etc., diagnoses, and prescription record were chosen and analyzed. SPSS software was also used for statistical analysis.ResultsThe number of patients with both diabetes and cancer rose from 220 cases in 2006 to 1,623 cases in 2013. The proportion of cancer patients with diabetes has also increased every year. Younger participants (aged ≤50 years) with diabetes had a greater risk of all cancers [P<0.005, odds ratio (OR) >3.4]. And cancer patients with diabetes occurs more frequently in male patients than in female patients, especially since 2009 the proportion has increased more evidently (P<0.005, OR >1.4). Further analysis showed that the level of blood lipid in patients with diabetes mellitus and cancer was significantly different from that in patients with simple diabetes mellitus (P<0.05).ConclusionsOur results clearly demonstrate a positive association between diabetes and cancer, especially in younger individuals aged less than 50 years. This finding highlights a need for greater awareness among public health workers and physicians of the importance of effective control of diabetes in the younger population.

Responding to COVID-19: The UW Medicine Information Technology Services Experience.

Background UW Medicine was one of the first health systems to encounter and treat COVID-19 patients in the United States, starting in late February 2020. Objective Here we describe the rapid rollout of capabilities by UW Medicine Information Technology Services (ITS) to support our clinical response to the COVID-19 pandemic and provide recommendations for health systems to urgently consider, as they plan their own response to this and potentially other future pandemics. Methods Our recommendations include establishing a hospital incident command structure that includes tight integration with IT, creating automated dashboards for incident command, optimizing emergency communication to staff and patients, and preparing human resources, security, other policies, and equipment to support the transition of all nonessential staff to telework. We describe how UW Medicine quickly expanded telemedicine capabilities to include most primary care providers and increasing numbers of specialty providers. We look at how we managed expedited change control processes to quickly update electronic health records (EHR) with new COVID-19 laboratory and clinical workflows. We also examine the integration of new technology such as tele–intensive care (ICU) equipment and improved integration with teleconferencing software into our EHR. To support the rapid preparation for COVID-19 at other health systems, we include samples of the UW Medicine's COVID-19 order set, COVID-19 documentation template, dashboard metric categories, and a list of the top 10 things your health care IT organization can do now to prepare. Conclusion The COVID-19 response requires new and expedited ways of approaching ITS support to clinical needs. UW Medicine ITS leadership hope that by quickly sharing our nimble response to clinical and operational requests, we can help other systems prepare to respond to this public health emergency.

Mobile Head Tracking for eCommerce and Beyond

Long term collections of human tissue or body fluids in biobanks combined with health-related data are important resources for medical research and the development of personal medicine in the future. At present, increasing number of clinical studies published new diagnostic, preventive options or treatment approaches of especially age related diseases such as diabetes, cancer or neurodegeneration. For some years, a rapid improvement in the mutual exchange of data and common quality assurance policies between biobanks can be observed especially in western countries. However, global web-based interfaces suitable to search for disease-related information and biomaterial are not yet in practice partly due to differences in national private policy laws and missing cooperative efforts between health care IT systems. In a new collaborative project between the Technical Hochschule of Brandenburg and the Faculty of Health Sciences, a joint Faculty of the Brandenburg University of Technology Cottbus-Senftenberg, the Brandenburg Medical School Theodor Fontane and the University of Potsdam, we try to fill this gap and review the technical and juristic requirements to accesses biomaterial and clinical data of US and European cancer patients ultimately leading to a concept for an international biobank network interface. Our aim is to provide instantly clinical data such as diagnostic and treatment approaches in real time that can be used by physicians and medical scientists from all over the world.

Exploring How Professionals Within Agile Health Care Informatics Perceive Visualizations of Log File Analyses: Observational Study Followed by a Focus Group Interview.

BackgroundAn increasing number of software companies work according to the agile software development method, which is difficult to integrate with user-centered design (UCD) practices. Log file analysis may provide opportunities for integrating UCD practices in the agile process. However, research within health care information technology mostly has a theoretical approach and is often focused on the researcher’s interpretation of log file analyses.ObjectiveWe aimed to propose a systematic approach to log file analysis in this study and present this to developers to explore how they react and interpret this approach in the context of a real-world health care information system, in an attempt to answer the following question: How may log file analyses contribute to increasing the match between the health care system and its users, within the agile development method, according to agile team members?MethodsThis study comprised 2 phases to answer the research question. In the first phase, log files were collected from a health care information system and subsequently analyzed (summarizing sequential patterns, heat mapping, and clustering). In the second phase, the results of these analyses are presented to agile professionals during a focus group interview. The interpretations of the agile professionals are analyzed by open axial coding.ResultsLog file data of 17,924 user sessions and, in total, 176,678 activities were collected. We found that the Patient Timeline is mainly visited, with 23,707 (23,707/176,678; 13.42%) visits in total. The main unique user session occurred in 5.99% (1074/17,924) of all user sessions, and this comprised Insert Measurement Values for Patient and Patient Timeline, followed by the page Patient Settings and, finally, Patient Treatment Plan. In the heat map, we found that users often navigated to the pages Insert Measurement Values and Load Messages Collaborate. Finally, in the cluster analysis, we found 5 clusters, namely, the Information-seeking cluster, the Collaborative cluster, the Mixed cluster, the Administrative cluster, and the Patient-oriented cluster. We found that the interpretations of these results by agile professionals are related to stating hypotheses (n=34), comparing paths (n=31), benchmarking (n=22), and prioritizing (n=17).ConclusionsWe found that analyzing log files provides agile professionals valuable insights into users’ behavior. Therefore, we argue that log file analyses should be used within agile development to inform professionals about users’ behavior. In this way, further UCD research can be informed by these results, making the methods less labor intensive. Moreover, we argue that these translations to an approach for further UCD research will be carried out by UCD specialists, as they are able to infer which goals the user had when going through these paths when looking at the log data.

Revisting Health Information Technology Ethical, Legal, and Social Issues and Evaluation: Telehealth/Telemedicine and COVID-19

Background: Information technologies have been vital during the COVID-19 pandemic. Telehealth and telemedicine services, especially, fulfilled their promise by allowing patients to receive advice and care at a distance, making it safer for all concerned. Over the preceding years, professional societies, governments, and scholars examined ethical, legal, and social issues (ELSI) related to telemedicine and telehealth. Primary concerns evident from reviewing this literature have been quality of care, access, consent, and privacy.Objectives: To identify and summarize ethical, legal, and social issues related to information technology in healthcare, as exemplified by telehealth and telemedicine. To expand on prior analyses and address gaps illuminated by the COVID-19 experience. To propose future research directions.Methods: Literature was identified through searches, forward and backward citation chaining, and the author’s knowledge of scholars and works in the area. EU and professional organizations’ guidelines, and nineteen scholarly papers were examined and categories created to identify ethical, legal, and social issues they addressed. A synthesis matrix was developed to categorize issues addressed by each source.Results: A synthesis matrix was developed and issues categorized as: quality of care, consent and autonomy, access to care and technology, legal and regulatory, clinician responsibilities, patient responsibilities, changed relationships, commercialization, policy, information needs, and evaluation, with subcategories that fleshed out each category. The literature primarily addressed quality of care, access, consent, and privacy. Other identified considerations were little discussed. These and newer concerns include: usability, tailoring services to each patient, curriculum and training, implementation, commercialization, and licensing and liability. The need for interoperability, data availability, cybersecurity, and informatics infrastructure also is more apparent. These issues are applicable to other information technologies in healthcare.Conclusions: Clinicians and organizations need updated guidelines for ethical use of telemedicine and telehealth care, and decision- and policy-makers need evidence to inform decisions. The variety of newly implemented telemedicine services is an on-going natural experiment presenting an unparalleled opportunity to develop an evidence-based way forward. The paper recommends evaluation using an applied ethics, context-sensitive approach that explores interactions among multiple factors and considerations. It suggests evaluation questions to investigate ethical, social, and legal issues through multi-method, sociotechnical, interpretive and ethnographic, and interactionist evaluation approaches. Such evaluation can help telehealth, and other information technologies, be integrated into healthcare ethically and effectively.

Внедрение информационных технологий в сфере здравоохранения

Внедрение информационных технологий в сфере здравоохранения

The Future of Human Being and Information Technology in Healthcare

The Future of Human Being and Information Technology in Healthcare

ТЕХНОЛОГИИ УПРАВЛЕНИЯ: ОТ ТЕОРИИ К ПРАКТИКЕ ПРИМЕНЕНИЯ В УЧРЕЖДЕНИЯХ ЗДРАВООХРАНЕНИЯ

Significance. Development and implementation of new medical and information technologies in healthcare, development of quality management system and digitalization are prioritized by the Decree of the President of the Russian Federation as of June 6, 2019 No.254 «On Strategy on healthcare development in the Russian Federation for the period until 2025». They are also mentioned in the list of key activities of the Ministry of Health of the Russian Federation in 2019-2024. Modern evidence-based management approaches are necessary to work in the mentioned fields, while the system development requires improvements including improvements in the management process based on best Russian and international practices in modern management in healthcare. Purpose. To assess the possibility of using modern management technologies to increase flexibility and efficiency of the medical organization. Material and methods. Analysis of domestic and foreign literature, normative legal documents for the period from 2015 to 2020 was carried out by means of theoretical analysis and synthesis using databases of the Russian Science Citation Index, Google Scholar, «Garant» reference system, open Internet sources and keywords search in Yandex search system. Results. Based on the analysis and guided by the functional principle, the authors have proposed a three-group classification of modern management technologies in healthcare allowing to structure the management process in a health care organization depending on the objectives. The groups include: 1) technologies that ensure development and implementation of organizational solutions; 2) technologies that ensure treatment and diagnostic process, quality and safety of health care; and 3) technologies for human resource management. Each group of technologies is represented by a set of organizational solutions, the characteristics of which are presented in this study. Conclusion. Application of flexible technologies is determined by the need to cope with changes in the business environment and to adapt the management system to new conditions. Due to objective restrictions related to the normative nature of the facility functioning and existing personnel limitations preventing development of the necessary managerial competencies of the staff, managers of health care organizations may not be able to properly attend to these issues. At the same time, the accumulated successful experience in implementing individual project management tools, the Agile method and other modern management technologies in the international practice suggest their possible replication to improve management processes in health care organizations in Russia. Scope of application. The study results can be used by healthcare managers, heads of health care organizations in developing and implementing managerial decisions, selecting modern tools and management technologies in order to achieve flexibility and efficiency of the institution's performance, as well as by regional authorities in public health in determining priorities for organizational development of health care organizations. Keywords: modern tools and methods of management in healthcare; project management; flexible management technologies.

Совершенствование медицинской помощи сельскому населению посредством управления бизнес-процессами

Meeting the needs of the rural population in all types of primary health care (pre-medical and general medical care), as well as specialized medical care, improving the quality of medical care for the rural population is an important public health problem that is difficult to solve and is of particular concern to government structures at all levels of government. The article presents an analysis of the literature on the use of business processes in modern healthcare, the main tasks of which are the creation and development of effective models for the provision of medical care that increase not only its accessibility and quality, but also the satisfaction of the population. As part of the activities of the modernization program for the implementation of information technology in healthcare, it is planned to create information resources and services that would allow, using this system tool, to move to a qualitatively new level of organization of industry management. It is noted that at present, at the level of management of the medical organization as a whole, and in the management of individual areas of its activity, the application of the process approach is becoming relevant, in which the medical organization can be considered as a separate business system, which is a related set of business processes, the ultimate goal which, undoubtedly, is the provision of quality medical services. It is shown that the development and modeling of business processes will increase the relevance of management information, will make it possible to focus on rationalizing cross-functional processes to significantly reduce time and / or costs, increase revenue, improve service quality and reduce risks, the information system allows you to simulate processes and carry them out further optimization. The analyzed works examine the experience of process-oriented management in medical organizations and its role in ensuring the improvement of the quality of medical services provided. In addition, the introduction of a process approach will allow the application of certain managerial decisions necessary in each specific situation, including in the field of medical services for the rural population.

Optimal Feature Selection-Based Medical Image Classification Using Deep Learning Model in Internet of Medical Things

Internet of Medical Things (IoMT) is the collection of medical devices and related applications which link the healthcare IT systems through online computer networks. In the field of diagnosis, medical image classification plays an important role in prediction and early diagnosis of critical diseases. Medical images form an indispensable part of a patient's health record which can be applied to control, handle and treat the diseases. But, classification of images is a challenging task in computer-based diagnostics. In this research article, we have introduced a improved classifier i.e., Optimal Deep Learning (DL) for classification of lung cancer, brain image, and Alzheimer's disease. The researchers proposed the Optimal Feature Selection based Medical Image Classification using DL model by incorporating preprocessing, feature selection and classification. The main goal of the paper is to derive an optimal feature selection model for effective medical image classification. To enhance the performance of the DL classifier, Opposition-based Crow Search (OCS) algorithm is proposed. The OCS algorithm picks the optimal features from pre-processed images, here Multi-texture, grey level features were selected for the analysis. Finally, the optimal features improved the classification result and increased the accuracy, specificity and sensitivity in the diagnosis of medical images. The proposed results were implemented in MATLAB and compared with existing feature selection models and other classification approaches. The proposed model achieved the maximum performance in terms of accuracy, sensitivity and specificity being 95.22%, 86.45 % and 100% for the applied set of images.

Comparative Analysis of Threat Modeling Methods for Cloud Computing towards Healthcare Security Practice

Healthcare organizations consist of unique activities including collaborating on patients care and emergency care. The sector also accumulates high sensitive multifaceted patients’ data such as text reports, radiology images and pathological slides. The large volume of the data is often stored as Electronic Health Records (EHR) which must be frequently updated while ensuring higher percentage up-time for constant availability of patients’ records. Healthcare as a critical infrastructure also needs highly skilled IT personnel, Information and Communication Technol-ogy (ICT) and infrastructure with regular maintenance culture. Fortunately, cloud computing can provide these necessary services at a lower cost. But with all thees enormous benefits of cloud computing, it is characterized with various information security issues which is not enticing to healthcare. Amid many threat modelling methods, which of them is suitable for identifying cloud related threats towards the adoption of cloud computing for healthcare? This paper compared threat modelling methods to determine their suitability for identifying and managing healthcare related threats in cloud computing. Threat modelling in pervasive computing (TMP) was identified to be suitable and can be combined with Attack Tree (AT), Attack Graph (AG) and Practical Threat Analysis (PTA) or STRIDE (spoofing, tampering, repudiation, information disclosure, denial of service and elevation of privilege). Also Attack Tree (AT) could be complemented with TMP, AG and STRIDE or PTA. Healthcare IT security professionals can hence rely on these methods in their security practices, to identify cloud related threats for healthcare. Essentially, privacy related threat modeling methods such as LINDDUN framework, need to be included in these synergy of cloud related threat modelling methods towards enhancing security and privacy for healthcare needs.

Discrepancies in information technology strategic alignment in healthcare

Information technology contributes significantly to the healthcare industry. Healthcare IT, if efficiently managed, can decrease expenses; enhance hospitals processes, patient satisfaction and care. From this perception, the necessity to improve information systems management becomes a significant governance and structural concern in hospitals. Therefore, it is fundamental to set an appropriate IT strategy, provide means to manage and implement it. IT strategic alignment is crucial to developing and maintaining all kind of information and communication that supports patients' treatment processes, business operations and ameliorates organisational social and economic performances. This study is a kind of action research project, and more specifically a qualimetrics intervention research methodology, a transformative approach, conducted in a private hospital in Lebanon. As technical systems are turning out to be more complex and indispensable to healthcare organisations, there is a rising awareness to preserve a sustainable environment, through maintaining intellectual, social and operational strategy of the organisation.

Discrepancies in information technology strategic alignment in healthcare

Information technology contributes significantly to the healthcare industry. Healthcare IT, if efficiently managed, can decrease expenses; enhance hospitals processes, patient satisfaction and care. From this perception, the necessity to improve information systems management becomes a significant governance and structural concern in hospitals. Therefore, it is fundamental to set an appropriate IT strategy, provide means to manage and implement it. IT strategic alignment is crucial to developing and maintaining all kind of information and communication that supports patients' treatment processes, business operations and ameliorates organisational social and economic performances. This study is a kind of action research project, and more specifically a qualimetrics intervention research methodology, a transformative approach, conducted in a private hospital in Lebanon. As technical systems are turning out to be more complex and indispensable to healthcare organisations, there is a rising awareness to preserve a sustainable environment, through maintaining intellectual, social and operational strategy of the organisation.

The 10th International Conference on Current and Future Trends of Information and Communication Technologies in Healthcare (ICTH 2020)

The 10th International Conference on Current and Future Trends of Information and Communication Technologies in Healthcare (ICTH 2020)

IOT SECURITY RISK MANAGEMENT MODEL FOR HEALTHCARE INDUSTRY

Internet of Things (IoT) is predicted as one of the biggest emerging environments in the future that creates simultaneous smart communication between machines or a variety of digital devices. Besides improving how data can be controlled, monitored and collected, IoT also allows us to generate revenue through the identifying of new business opportunities and deployment of advanced analytics processes for decision-making purposes. IoT enables us to accelerate changes in the healthcare environment in improving patient engagement and outcome, as well as transforming healthcare from reactive to proactive accessibility. Nevertheless, IoT’s expansion brings new vulnerabilities, risk and security challenges for healthcare practitioners and their patients. However, there is still a lack of study focusing on IoT risk management in healthcare. Existing researches tend to focus only on the implementation of IoT peripherals in a healthcare environment and tend to embed the secured applications solution with it. Since healthcare information and data are highly confidential, it is important to ensure that a secured health IoT application is in place. Thus, the aim of this study is to investigate the IoT risk management aspects in a healthcare environment with particular attention to proposing a step-by-step process of an IoT risk management model. The proposed IoT risk management model was developed leveraging on DEMATEL IoT Risk Assessment Procedure. This study was conducted based on a case study of one hospital in Sudan which has recently invested in IoT technologies in their operation. Interviews were conducted with selected respondents from the hospital and findings suggested that the selected case study does not have an established IoT risk management mechanism due to the ad-hoc IoT implementation approach. The case study also lacks of protection for health data and information with several unclear work process. As a solution, this study proposes an enhanced IoT risk management model for healthcare with consideration of three risk categories; 1) Secured Technology, 2) Human Privacy and 3) Trustable Process and Data. The proposed model was then evaluated by three IoT experts and two IT healthcare practitioners based on System Usability Score (SUS) and received Good Usability score which means the model is usable as a healthcare IoT risk management model.

An Implementation of New Qr Based Encryption Algorithm For Secure Medical Data In Cloud Storage

Healthcare Information technology encryption is more and more popular alternative in terms of retaining sensational records inclusive of patient PHI. With more carriers implementing IOT, EHR-Connectivity and usage of linked gadgets, the problem over whether encryption is important is important is an extra widely wide-spread. Encryption of health data is while companies change information into encoded textual content, which makes the facts unreadable unless a person has a key or code to decrypt it. This could be a terrific choice for covered entities or commercial enterprise buddies that regularly manage electronic PHI (ePHI) and want to make sure unauthorized customer can’t admit to get the information. In this paper discussed about the new QR based encryption Algorithm for secure medical data which is stored inside of the cloud.

Information technologies in healthcare: Enhancing or dehumanising doctor-patient interaction?

Since the very emergence of the information technologies in healthcare, a major concern has been raised about the potential of remote services to undermine the intimacy, immediacy and humanity intrinsic to conventional, face-to-face medical practice. By contrast, notable literature reports the benefits of information technology-mediated services and their potential to improve efficiency and economic convenience of healthcare systems. This article aims to shed light on this ambivalence by retracing the evolution of doctor-patient interaction in relation to the main technological advancements in healthcare, and in particular, to services mediated by information technologies. Consequently, the reduction of cues and clues associated with the use of these services is framed into the reductionism of the biomedical paradigm, which provides a key to interpret the nature, scope and features of this process of technological innovation, along with its potential and limits.

Digital Diagnostics and Therapeutics

Information technology (IT) has much to offer for the healthcare. Healthcare IT covers a broad range of computer and technological advancement used in its environments and tools such as electronic health records (EHR), laboratory and medical imaging information systems, use of dedicated medical devices and facilitation of healthcare communication. It also supports the diagnostic ability for the healthcare members and enhance treatment deliveries reflecting patient-centered approach. However, despite vast challenges involve in the development and maintenance of these complex systems as a platform to hold enormous clinical and diagnostic information for huge number of patients, very little of these captured data are involved in the entire aspect of surgica l diagnostics and therapeutics. In most clinical situations, it merely serves for record keeping with minimal involvement in shaping the surgical workflow, perioperative clinical decision making or to enhance surgical deliveries. The aim of this presentation was to highlight our institutional experience with the utilization of various advance digital diagnostics and therapeutic software and tools for surgical management of jaw tumors and maxillofac ia l fracture reconstruction, with emphasis on orbital blowout fracture reconstruction. Bridging and personalized diagnostic procedures for therapeutic or surgical use, pre-procedural or virtual planning, image-guided surgery and perioperative surgical control and check with the use of computer technology will be highlighted in this presentation. It is hoped that this presentation could serve as sharing and learning platform for all conference delegates with regards to the revolutionary digital diagnostic and therapeutic trends in some aspect of oral and maxillofac ia l surgical procedures.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 15

Healthcare IT Innovations and Cost Savings: Explore How Recent Innovations in Healthcare IT Have led to Cost Savings and Economic Benefits within the Healthcare System

Healthcare IT Innovations and Cost Savings: Explore How Recent Innovations in Healthcare IT Have led to Cost Savings and Economic Benefits within the Healthcare System

The efficiency analysis and spatial implications of health information technology: A regional exploratory study in China.

The new adoption of healthcare information technology is costly, and effects on healthcare performance can be questionable. This nationwide study in China investigated the efficient performance of healthcare information technology and examined its spatial correlation. Panel data were extracted from the Annual Investigation Report on Hospital Information in China and the China Health Statistics Yearbook for 2007 through 2015 (279 observations). Stochastic frontier analysis was employed to estimate the technical efficiency of healthcare information technology performance and related factors at the regional level. Healthcare information technology performance was positively associated with electronic medical records, total input, and cost of inpatient stay, while picture archiving and communication systems and net assets were negatively related. Local Indicators of Spatial Association showed that there existed significant spatial autocorrelation. Governmental policies would best make distinctions among different forms of healthcare information technology, especially between electronic medical records and picture archiving and communication systems. Policies should be formulated to improve healthcare information technology adoption and reduce regional differences.