Healthcare Information Management Systems Research Articles

A holistic insight into the privacy & security of cloud-based computing approach on healthcare information management systems in the United States – a grounded theory approach

A holistic insight into the privacy & security of cloud-based computing approach on healthcare information management systems in the United States – a grounded theory approach

Assessment of clinical miscoding errors and potential financial their implications on healthcare management – A case of local hospital in Najran, Saudi Arabia

BackgroundHealthcare systems can potentially improve their safety, quality of service, and performance efficiency with a cost reduction, through the introduction and implementation of healthcare information management systems. This study aims to examine the frequency of miscoding errors in principal and secondary diagnoses, exploring demographic and coder-related factors contributing to these errors through the use of the QuadraMed system. The study also investigates the association of coding errors with patient safety and service quality to estimate the potential financial implications resulting from these inaccuracies in the healthcare system. MethodsThis analytical cross-sectional retrospective study was conducted at a local hospital in Najran, Saudi Arabia, from July 2021 to February 2022 using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) coding system. The costing and financial data were collected from the reimbursement department for eligible 750 patient cases in terms of payment mode, services availed, and length of stay. The financial claims were evaluated to estimate the impact on the quality of service and patient safety. The reimbursement amount was calculated based on codes. The data were analyzed using SPSS and the odds ratio was calculated to estimate the risk of major coding errors in different departments. ResultsPrimary codes 240 (32%) and 40 (5.3) secondary codes were reviewed and percentages and inaccuracies were calculated after recording. The percentage of inaccurate medical codes in principal diagnosis was 57(26.8%) and the percentage of inaccurate medical codes in secondary diagnosis was 21 (9.9%). The primary diagnostic codes have more coding errors with a total number of 240 (32%) coding errors with a moderate level of agreement between the original coder and independent coder with a kappa value of 0.462. The identified recording was done by the independent coder, and the secondary diagnostic code showed 40 (5.3%) cases, with a poor kappa value of 0.128. The results showed the highest number of primary diagnostic codes was among surgery clinics 79 (63.2%). The highest number of secondary diagnostic codes were reported among consultant clinics 12 (9.6%) ConclusionsThe study concludes that the identification of miscoding in the healthy population has a financial impact on the healthcare organization's infrastructure.

Bluetooth-Based Healthcare Information and Medical Resource Management System.

This paper presents a healthcare information and medical resource management platform utilizing wearable devices, physiological sensors, and an indoor positioning system (IPS). This platform provides medical healthcare information management based on the physiological information collected by wearable devices and Bluetooth data collectors. The Internet of Things (IoT) is constructed for this medical care purpose. The collected data are classified and used to monitor the status of patients in real time with a Secure MQTT mechanism. The measured physiological signals are also used for developing an IPS. When the patient is out of the safety zone, the IPS will send an alert message instantly by pushing the server to remind the caretaker, easing the caretaker's burden and offering extra protection for the patient. The presented system also provides medical resource management with the help of IPS. The medical equipment and devices can be tracked by IPS to tackle some equipment rental problems, such as lost and found. A platform for the medical staff work coordination information exchange and transmission is also developed to expedite the maintenance of medical equipment, providing the shared medical information to healthcare and management staff in a timely and transparent manner. The presented system in this paper will finally reduce the loading of medical staff during the COVID-19 pandemic period.

Analysis of the Exploration of Security and Privacy for Healthcare Management Using Artificial Intelligence: Saudi Hospitals.

A large component of the Health Information Systems now comprises numerous independent apps created in the past that need to be merged to provide a more uniform service. In addition to affecting the Intelligent Health Board Functionality and dependability, the quality of these additional apps may also have an impact. A critical characteristic of the SHS's management and upkeep is the SHS's reliance on the real benefits provided to it. In speaking, an HMIS (Healthcare Management Information System) is a computer-based device that benefits medical practitioners to perform their duties more efficiently by coordinating all of their data. Even though these systems are widely used by most of the world, there is a significant need to comprehend these technologies and indeed the potential they provide. Healthcare data warehouses in Saudi Arabia have evolved through time, and this research examines how key service improvements in Saudi present varied viewpoints on how premium initiative help may be attained in health as well as how this could be done. When it comes to understanding how different types of medical professionals interact with healthcare systems throughout history, researchers developed stages of the maturity model.

Bacterial and Fungal Coinfection in Critically Ill COVID-19 Cases and Predictive Role of Procalcitonin During the First Wave at an Academic Health Center

BackgroundCoinfection at various sites can complicate the clinical course of coronavirus disease of 2019 (COVID-19) patients leading to worse prognosis and increased mortality. We aimed to investigate the occurrence of coinfection in critically ill COVID-19 cases, and the predictive role of routinely tested biomarkers on admission for mortality.MethodsThis is a retrospective study of all SARS-CoV-2-infected cases, who were admitted to King Fahad Hospital of the University between March 2020 and December 2020. We reviewed the data in the electronic charts in the healthcare information management system including initial presentation, clinical course, radiological and laboratory findings and reported all significant microbiological cultures that indicated antimicrobial therapy. The mortality data were reviewed for severely ill patients who were admitted to critical care units.ResultsOf 1091 admitted patients, there were 70 fatalities (6.4%). 182 COVID-19 persons were admitted to the critical care service, of whom 114 patients (62.6%) survived. The in-hospital mortality was 13.4%. Coinfection was noted in 67/68 non-survivors, and Gram-negative pathogens (Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumanni) represented more than 50% of the etiological agents. We noted that the serum procalcitonin on admission was higher for non-survivors (Median = 1.6 ng/mL ± 4.7) than in survivors (Median = 0.2 ng/mL ± 4.2) (p ≤ 0.05).ConclusionCoinfection is a serious complication for COVID-19 especially in the presence of co-morbidities. High levels of procalcitonin on admission may predict non-survival in critically ill cases in whom bacterial or fungal co-infection is likely.

Agile Sof t ware Development of Clinical Healthcare Management Information System for Public Health

Organization should manage information just as like as it manages its other resources correctly to fully maximize the usefulness of information especially in the field of healthcare. The use of software model to create information systems made it possible. To support the healthcare of the community, the appearance of Rural Health Unit is much needed. This study will discuss the problems encountered by the health professionals and health workers of Rural Health Unit in the Province of Alaminos, Laguna on the existing manual processes of storing and retrieving of patients’ data that are mainly used in assessing the public health of the community. With this situation, the researchers developed a Clinical Healthcare Management Information System for public health. This paper will also focus on the development of the system using Agile model and evaluation adapted from ISO 25010 to test its effectiveness.

Elements of the care environment influence coronary artery bypass surgery readmission

BackgroundCoronary artery bypass grafting 30-day unplanned readmission is a focus for the CMS Hospital Readmissions Reduction Program. Awareness of the critical elements of the care delivery environment, including hospital infrastructure and patient clinical profiles that predispose toward readmission, is essential to proactively decrease readmissions. MethodsThe Healthcare Cost and Utilization Project-State Inpatient Database, American Hospital Association Annual Health Survey Database, and Healthcare Information Management Systems Society data sets were merged to create a single data set of patient- and hospital-level data from 8 states. Isolated coronary artery bypass grafting procedures were queried for all-cause 30-day readmission, and backwards stepwise logistic regression was performed. Readmission rate was then used to categorize hospitals into quartiles, and analysis focused on the hospitals with the lowest (Q1) and highest (Q4) readmission rates. Univariate analysis was performed comparing Q1 and Q4 hospitals. ResultsA total of 150,215 patients underwent isolated coronary artery bypass grafting with 23,244 (15.5%) readmitted patients among 903 hospitals. Model area under the curve was 0.709 (95% confidence interval, 0.702–0.716), with the top 3 readmission determinants related to discharge disposition. Compared to Q1, Q4 patients more often were female, were >70 years of age, and had Medicare as a primary payor (P < .001). Low readmission rate hospitals were characterized by higher costs; not-for-profit status; having Joint Commission accreditation; and higher total admissions, operative volume, hospital/ICU beds, full-time physicians, nurses, and ancillary personnel (P < .001). ConclusionReadmission after coronary artery bypass grafting is strongly influenced by discharge disposition. However, hospital factors such as scale, personnel, and ownership structure are significant contributors to readmission. Focus beyond patient factors to include the entire continuum of care is required to enhance outcomes, of which readmission is one surrogate measure.

Big data analytics in healthcare A systematic literature review and roadmap for practical implementation

The advent of healthcare information management systems (HIMSs) continues to produce large volumes of healthcare data for patient care and compliance and regulatory requirements at a global scale. Analysis of this big data allows for boundless potential outcomes for discovering knowledge. Big data analytics (BDA) in healthcare can, for instance, help determine causes of diseases, generate effective diagnoses, enhance QoS guarantees by increasing efficiency of the healthcare delivery and effectiveness and viability of treatments, generate accurate predictions of readmissions, enhance clinical care, and pinpoint opportunities for cost savings. However, BDA implementations in any domain are generally complicated and resource-intensive with a high failure rate and no roadmap or success strategies to guide the practitioners. In this paper, we present a comprehensive roadmap to derive insights from BDA in the healthcare (patient care) domain, based on the results of a systematic literature review. We initially determine big data characteristics for healthcare and then review BDA applications to healthcare in academic research focusing particularly on NoSQL databases. We also identify the limitations and challenges of these applications and justify the potential of NoSQL databases to address these challenges and further enhance BDA healthcare research. We then propose and describe a state-of-the-art BDA architecture called Med-BDA for healthcare domain which solves all current BDA challenges and is based on the latest zeta big data paradigm. We also present success strategies to ensure the working of Med-BDA along with outlining the major benefits of BDA applications to healthcare. Finally, we compare our work with other related literature reviews across twelve hallmark features to justify the novelty and importance of our work. The aforementioned contributions of our work are collectively unique and clearly present a roadmap for clinical administrators, practitioners and professionals to successfully implement BDA initiatives in their organizations.

Genome-wide analysis of therapeutic response uncovers molecular pathways governing tamoxifen resistance in ER+ breast cancer.

BackgroundPrioritization of breast cancer patients based on the risk of resistance to tamoxifen plays a significant role in personalized therapeutic planning and improving disease course and outcomes.MethodsIn this work, we demonstrate that a genome-wide pathway-centric computational framework elucidates molecular pathways as markers of tamoxifen resistance in ER+ breast cancer patients. In particular, we associated activity levels of molecular pathways with a wide spectrum of response to tamoxifen, which defined markers of tamoxifen resistance in patients with ER+ breast cancer.FindingsWe identified five biological pathways as markers of tamoxifen failure and demonstrated their ability to predict the risk of tamoxifen resistance in two independent patient cohorts (Test cohort1: log-rank p-value = 0.02, adjusted HR = 3.11; Test cohort2: log-rank p-value = 0.01, adjusted HR = 4.24). We have shown that these pathways are not markers of aggressiveness and outperform known markers of tamoxifen response. Furthermore, for adoption into clinic, we derived a list of pathway read-out genes and their associated scoring system, which assigns a risk of tamoxifen resistance for new incoming patients.InterpretationWe propose that the identified pathways and their read-out genes can be utilized to prioritize patients who would benefit from tamoxifen treatment and patients at risk of tamoxifen resistance that should be offered alternative regimens.FundingThis work was supported by the Rutgers SHP Dean's research grant, Rutgers start-up funds, Libyan Ministry of Higher Education and Scientific Research, and Katrina Kehlet Graduate Award from The NJ Chapter of the Healthcare Information Management Systems Society.

The Impact of the Moderating Effect of Psychological Health Status on Nurse Healthcare Management Information System Usage Intention

Nurses play a key role in healthcare but work in a highly stressful and unfriendly environment. Therefore, many medical institutions have adopted nurse healthcare management information systems for nurses to relieve symptoms of mental stress and even improve their psychological health. The key to the success of these systems depends on how nurses intend to use them. In this study, the moderating effect of nurses’ psychological health status on their usage of these systems are discussed. This study used a mail survey method for nurses to obtain 1565 valid samples. The results show that perceived usefulness is insignificant toward the usage intention of nurses with a positive psychological health status, which indicates that this system does not meet the needs of these healthy nurses. Furthermore, perceived ease of use is insignificant toward the usage intention of nurses with a negative psychological health status, which indicates that a negative psychological health status may affect one’s behavior due to impatience. This study raises the serious issue that nurses should maintain their psychological health in order to ensure the quality of care for patients. People in various fields are expected to pay attention to the psychological health status of nurses and create a win–win situation for both patients and nurses.

TOPICALITY OF IMPLEMENTATION OF MOBILE MEDICAL APPLICATIONS WITHIN THE FRAMEWORK OF ELECTRONIC HEALTH IN UKRAINE: THE EXPERIENCE OF LEADING COUNTRIES OF THE WORLD

Today, in the field of healthcare of the leading countries of the world there is a technological breakthrough due to the use of modern electronic systems. Thanks to the use of medical electronic technologies, it is possible to improve the quality of medical and pharmaceutical care for all segments of the population. The eHealth system provides opportunities for direct participation of patients in their health, which involves organization of a healthy lifestyle and disease prevention. The aim of the study was to analyze the experience of implementation of mobile medical applications and electronic medical systems within eHealth in the healthcare systems of the leading countries of the world and Ukraine. Materials and Methods of the Ministry of Health of Ukraine, FDA, WHO, NHS, ABI Research and other open information databases and statistical agencies were used in the work. The analytical, comparative and generalization of scientific information methods were chosen for the research. Results and Discussion. Modern reformation and further development of the healthcare system of Ukraine provides for the introduction of not only government programs of reimbursement, but also the introduction of electronic information systems, mobile applications for medical, pharmaceutical workers and patients at all stages of medical and pharmaceutical care. The integrated implementation of eHealth determines availability of the necessary healthcare management information system, which should have the following components: registers of medical institutions, services, doctors, patients, diagnosis coding system and electronic medical documentation (electronic medical records and prescriptions). Currently, 1472 medical institutions, 24506 doctors and 21068249 patients have joined eHealth in Ukraine. Conclusions. It has been determined that information electronic technologies allow not only to reduce government spending on the healthcare, but also to achieve a reduction in the number of errors in prescriptions, visits to doctors without the necessary needs and decrease the total number of deaths. The introduction of electronic technologies, in particular mobile applications for the national healthcare system in Ukraine should be controlled by state authorities and independent international organizations on the control and development of information electronic systems.

English

English

Improving inpatient mental health medication safety through the process of obtaining HIMSS Stage 7: a case report.

Although electronic health record systems have been implemented in many health settings globally, how organizations can best implement these systems to improve medication safety in mental health contexts is not well documented in the literature. The purpose of this case report is to describe how a mental health hospital in Toronto, Canada, leveraged the process of obtaining Healthcare Information Management Systems Society (HIMSS) Stage 7 on the Electronic Medical Record Adoption Model to improve clinical care specific to medication safety in its inpatient settings. Examples of how the organization met several of these HIMSS criteria are described as they relate to utilizing data from the system to support clinician practice and/or decision-making for medication safety.

Characteristics of the healthcare information technology workforce in the HITECH era: underestimated in size, still growing, and adapting to advanced uses.

ObjectiveThere is little readily available data about the size and characteristics of the healthcare information technology workforce. We sought to update a previous description of the size, growth, and characteristics of this workforce based on the Healthcare Information Management Systems Society (HIMSS) Analytics® Database, a resource that includes hospital size, number of beds, amount of staffing, and an eight-stage model of electronic health record adoption (Electronic Medical Record Adoption Model, EMRAM℠).Materials and MethodsWe updated an analysis done using a 2007 snapshot of the HIMSS Analytics Database with a comparable snapshot from 2014 in order to estimate the size of the current workforce and project future needs. For the 2014 data, we applied the same weighted average analysis used in 2007 to obtain a ratio of information technology (IT) hospital full-time equivalent (FTE) to staffed beds, extrapolate the results to all US hospitals, and project the workforce needs as hospitals achieve higher EMRAM stages.ResultsOur estimated size of the healthcare information technology workforce in the US in 2014 was 161 160, which was 8.0% larger than the estimate based on the 2007 data. Based on the new data, we project a potential need for an additional 19 852 and 153 114 FTE, if all hospitals were to achieve EMRAM Stages 6 and 7, respectively. The distribution of FTE across job function category varies by EMRAM stage.Discussion and ConclusionsAlthough these data are limited, especially for EMRAM Stage 7, there is likely need for substantial workforce growth as hospitals increase their adoption of advanced healthcare information technology. Further research with data better focused on workforce characteristics will provide a better picture of staffing requirements.

Distribution and associated factors of high-risk HPV genotypes infection among HPV-positive women who participated cervical screening test in Shenzhen, 2014-2016, China

Objective: To analyze the distribution and associated factors of high-risk genotypes of HPV in cervical infection among women in Shenzhen. Methods: The information on sociodemographic characteristics and HPV genotypes of HPV-positive women who participated cervical screening test from January 2014 to December 2016 was downloaded from Shenzhen Maternity and Child Healthcare Management Information System. According to the pathogenicity, the high-risk HPV genotypes were divided into 15 types including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68; and there were 6 low-risk genotypes including HPV 6, 11, 42, 43, 44, and 81. Chi-square tests were applied to compare the proportions of high-risk HPV infection among women who had different sociodemographic characteristics. A non-conditional logistic regression model was used to analyze the associated factors for high-risk HPV infection. Results: In total, all HIV positives received HPV genotyping, with an average age of (38.08±9.38) years old. There were 9 979 (93.9%) high-risk and 645 (6.1%) low-risk HPV infections. The proportions of HPV infections for high-risk type in each year were 91.5%, 93.8%, and 95.6%, increasing with the screening years (χ(2)=54.79, P<0.001). Multivariate logistic regression analysis showed that compared with women younger than 25 years old, women in other age groups (at age 26 to 30 years, 31 to 35 years, 36 to 40 years, 41 to 45 years, and 50 years or older) had increased risks of high-risk HPV infection, with OR (95%CI) of 1.67 (1.20-2.31), 1.49 (1.09-2.03), 1.71 (1.23-2.37), 1.65 (1.19-2.31), and 1.84 (1.26-2.67), respectively; compared with the married, single women had a decreased risk of high-risk HPV infection (OR (95%CI): 0.71 (0.50-1.00)); women received HPV testing in 2015 and 2016 showed higher risk of high-risk HPV infection than those in 2014 (OR (95%CI): 1.43 (1.17-1.74) and 2.03 (1.68-2.46)). The 5 most common HPV genotypes were HPV52 (25.1%, 2 670 cases), followed by HPV16 (19.2%, 2 041 cases), HPV58 (13.3%, 1 413 cases), HPV18 (9.9%, 1 048 cases), and HPV51 (9.3%, 993 cases). Conclusion: Age, marital status, and screening year were associated with high-risk HPV infections. Besides HPV16 and HPV18, the prevention and control on HPV infections for HPV52, HPV58, and HPV51 should be prioritized in Shenzhen area.

Talking the Talk: Financial Skills for Nurse Leaders

The importance of effective execution of financial management may be more arguably more relevant today than when first established by the Healthcare Leadership Alliance (HLA) over a decade ago. Since the 6 key health care agencies (American College Healthcare Executives [ACHE], American College of Physician Executives [ACPE], American Organization of Nurse Executives [AONE], Healthcare Finance Management Association [HFMA], Healthcare Information Management Systems Society [HIMSS], and Medical Group Management Association [MGMA]) convened and identified 5 core competencies shared by all health care leaders. The key imperatives included communication and relationship management, professionalism, knowledge of the health care environment, leadership, and business acumen. 1 Although the health care landscape has continued to evolve, these essential skills remain relevant today. Administrators must lead through ever-changing reimbursement models, work to continually improve patient satisfaction indicators, affect hospital quality metrics, and close the labor shortage gap during a time of political unknowns of health care reform. The demand for care, coupled with comorbidities of an aging population, and a diminishing supply as Baby Boomer nurses retire, has led to stress on health care systems across the nation. As the general population ages, so, too, does the nursing workforce. The average age of the registered nurse is 50 years or greater. 2 The Bureau of Labor Statistics estimates a nurse vacancy rate of 1.09 million by 2024. 3

Preserving patients’ privacy in health scenarios through a multicontext-aware system

The Big Data age is characterized by the explosive increase of data managed by electronic systems. Healthcare Information Management systems are aware of this situation having to adapt services and procedures. This, along with the fact that the proliferation of mobile devices and communications has also promoted the use of context-aware services ubiquitously accessible, means that protecting the privacy of the patients’ information is an even greater challenge. To address this issue, a mechanism that allows patients to manage and control their private information is required. We propose the preservation of patients’ privacy in a health scenario through a multicontext-aware system called h-MAS (health-related multicontext-aware system). h-MAS is a privacy-preserving and context-aware solution for health scenarios with the aim of managing the privacy of the users’ information in both intra- and inter-context scenarios. In a health scenario, h-MAS suggests a pool of privacy policies to users, who are aware of the health context in which they are located. Users can update the policies according to their interests. These policies protect the privacy of the users’ health records, locations, as well as context-aware information being accessed by third parties without their consent. The information on patients and the health context is managed through semantic web techniques, which provide a common infrastructure that makes it possible to represent, process, and share information between independent systems more easily.

The Impact of National Formulary on Cough Medicine Prescribing in Three Primary Health Care in Depok

: Objective: To evaluate the use of cough medicine in Acute Respiratory Infections (ARI) patients in three primary health care in Depok in 2015 and suitability with the National Formulary. Method: The study design was descriptive analytic with retrospectively data collection from patient’s prescription, Primary Health Care Management Information System (SIMPUS), and Medicine Management Information System (SIPO). Samples are taken from ARI’s patients prescription from January until December 2015. The analysis was conducted on the prescription that meets the inclusion criteria quantitatively and qualitatively. Quantitative analysis is expressed in DDD and DDD/1000 patients/day. Results: The primary health care that has the biggest quantity of Medicines usage for DDD was in Cipayung (59136, 33g). Then, DDD/1000 patients/day for glyceryl guaiacolate, ambroxol, and dextromethorphan respectively was in Cipayung (14.971g), Limo (1.129 g), and Limo (0,0006g). The primary health care that most suitable with the National Formulary was Conclusion: In conclusion, all the cough medicine use in ARI patients in the three primary health care facilities in Depok in 2015 was unsuitable according to the National Formulary recommendations. Therefore, cough medicine use is needed to be evaluated further.Key words: ATC/DDD, Cough, Cough medicine, Depok Primary Health Care, National Fomulary.

Investigation of children's deciduous teeth erupt, fontanel closure and language, gross motor development in Zhengzhou

Objective To understand the children's development status of deciduous teeth erupt, fontanel closure, expressive language and gross motor in Zhengzhou. Methods According to random cluster sampling, the children health care clinic in three hospitals in Zhengzhou were investigated, all the data was gathered from the children health care management information system.4 230 healthy children aged 0- 3 years old birth from 2000 to 2010 were investigated(2 141 boys and 2 089 girls), We collected the following information about birth situation, the dynamic physical growth, deciduous tooth occurrence, language and motor development. Results (1)The children's weight, height has been persistent and significantly improved during the past 10 years in Zhengzhou.(2)There was a significant difference between the sexes in deciduous teeth erupt and the fontanel closure time.(3)With the time,infant motor development and fontanelle closed slightly ahead of time. Conclusion The children's weight, height growth shows a long- term trend in Zhengzhou, with normal condition in neuropsychological development, and presents a slightly ahead of the trend. Key words: Growth and development; Deciduous teeth erupt; The fontanel closure time; Child

Biomedical Signal Processing and Modeling Complexity of Living Systems 2014

Biomedical Signal Processing and Modeling Complexity of Living Systems 2014