Healthcare Research Research Articles

Finding the Missing Men with Tuberculosis: A Participatory Approach to Identify Priority Interventions in Uganda.

Gender impacts exposure and vulnerability to TB, evidenced by a higher prevalence of both TB disease and missed TB diagnoses among men, who significantly contribute to new TB infections. We present the formative research phase of a study which used participatory methods to identify gender-specific interventions for systematic screening of TB among men in Uganda. Health facility level data was collected at four Ugandan general hospitals (Kawolo, Gombe, Mityana, and Nakaseke) among 70 TB stakeholders, including healthcare workers, TB survivors, policymakers, and researchers. Using health seeking pathways, they delineated and compared men's ideal and actual step-by-step TB health seeking processes to identify barriers to TB care. The stepping stones method, depicting barriers as a 'river' and each 'steppingstone' as a solution, was employed to identify interventions which would help link men with TB symptoms to care. These insights were then synthesized in a co-analysis meeting with 17 participants including representatives from each health facility to develop a consensus on proposed interventions. Data across locations revealed the actual TB care pathway diverted from the ideal pathway due to health system, community, health worker and individual level barriers such as delayed health seeking, unfavourable facility operating hours and long waiting times that conflicted with men's work schedules. Stakeholders proposed to address these barriers through the introduction of male-specific services; integrated TB services that prioritize X-ray screening for men with cough; healthcare worker training modules on integrated male-friendly services; training and supporting TB champions to deliver health education to people seeking care; and engagement of private practitioners to screen for TB. In conclusion, our participatory co-design approach facilitated dialogue, learning, and consensus between different health actors on context-specific, person-centred TB interventions for men in Uganda. The acceptability, effectiveness and cost effectiveness of the package will now be evaluated in a pilot study.

Borderlands: A Place of Transformation for Nursing-Where Nepantleras Thrive.

Spaces produced in healthcare settings and research institutions tend to perpetuate marginalized populations' state of social otherness. We believe nurses from borderlands are best suited to walk between dominant (striated) spaces and margins in healthcare settings. Borderlands is a liminal space where multiple identities, places, cultures, paradigms, or ways of thinking intersect. We believe nurses can navigate these spaces by becoming walkers/travelers between worlds or as nepantleras Anzaldúa's critical rhetorical analysis framework can assist borderlands nurses to create geographies of inclusion for equity-denied groups as it is within these borderlands spaces that the dominant narratives are relegated to the margins and new spaces are imagined.

Avoidable Hospitalizations in the Military Health System, Fiscal Years 2018-2019.

Ongoing health reforms in the Military Health System (MHS) are expected to shift locations of ambulatory care for up to 1.9 million beneficiaries. We sought to model the impact of this policy by determining potentially avoidable hospitalizations in the MHS based on different primary care settings. We used the MHS Data Repository to conduct a retrospective cross-sectional study of TRICARE Prime and Prime Plus beneficiaries aged 18 to 64 years during fiscal years 2018-2019. Crude and adjusted risk ratios for each Agency for Healthcare Research and Quality prevention quality indicator based on primary care setting were calcualated to determine the total probability of admission for any of the Agency for Healthcare Research and Quality prevention indicators. We identified a total of 260,690 hospital admissions by patients in the MHS with a designated primary care manager (PCM) from fiscal year 2018 to 2019. Of the total admissions, 11,067 (4.25%) were for Agency for Healthcare Research and Quality prevention quality indicators, 3.63% by direct care PCM at a military treatment facility, and 0.61% by a civilian private sector PCM. Risk of admission was lower for private sector PCMs for urinary tract infection, hypertension, perforated appendix, and angina without the procedure. We did not observe a statistically significant adjusted odds ratio of admission in patients managed by private sector PCMs (1.04 adjusted odds ratio; 95% CI, 0.97-1.11). Our findings indicate no difference in the likelihood of avoidable hospitalizations for beneficiaries with a private sector PCM when looking at all conditions together. Patients with a private sector PCM are protected against hospitalization for several conditions. Our findings indicate no adverse impact on avoidable hospitalizations for beneficiaries transitioned to private sector care from direct care.

Where Are the Costs? Using an Economic Analysis of Educational Interventions Approach to Improve the Evaluation of a Regional School Improvement Programme

Education systems are moving to a more evidence-informed paradigm to improve outcomes for learners. To help this journey to evidence, robust qualitative and quantitative research can help decisionmakers identify more promising approaches that provide value for money. In the context of the utilisation of scarce resources, an important source of evidence commonly used in health and social care research is an understanding of the economic impact of intervention choices. However, there are currently very few examples where these methodologies have been used to improve the evaluation of education interventions. In this paper we describe the novel use of an economic analysis of educational interventions (EAEI) approach to understand both the impact and the cost of activities in the evaluation of a formative assessment implementation project (FAIP) designed to improve teachers’ understanding and use of formative assessment strategies. In addition to utilising a mixed method quasi-experimental design to explore the impact on learner wellbeing, health utility and attainment, we describe the use of cost-consequence analysis (CCA) to help decisionmakers understand the outcomes in the context of the resource costs that are a crucial element of robust evaluations. We also discuss the challenges of evaluating large-scale, universal educational interventions, including consideration of the economic tools needed to improve the quality and robustness of these evaluations. Finally, we discuss the importance of triangulating economic findings alongside other quantitative and qualitative information to help decisionmakers identify more promising approaches based on a wider range of useful information. We conclude with recommendations for more routinely including economic costs in education research, including the need for further work to improve the utility of economic methods.

He/She/They - gender inclusivity in developing and using health-related questionnaires: a scoping review.

To ensure the recognition and participation of all potential respondents in health research, surveys and care, including LGBTQIA + broadly, and trans people, specifically, the use of inclusive language should be considered. This scoping review aimed to identify and describe strategies considered for gender inclusivity in development and use of health questionnaires and Patient Reported Outcomes Measures (PROMs). A systematic search of peer reviewed publications between January 2000 and September 2022 was conducted in Scopus, ProQuest Central, Ovid Medline (PubMed and EBSCO). Two reviewers independently screened identified publications titles and abstracts, followed by full text screening and data extraction from eligible articles. The search of over 5000 publications, retained 18; most acknowledged gaps in representation and advocated for gender-inclusive language. Eight articles discussed exclusion from health care and health research for gender minority groups due to the use of gendered language. Improved reliability, validity and response rates were associated with the use of gender-neutral language in seven articles. Only one article reported finding irritation among cisgender males when non-binary gender response options were used. One paper, focussing on instruments for Rheumatoid Arthritis, discussed gaps in representation if diverse gender identities were not considered when developing PROMs. This scoping review points to the importance of adopting gender-inclusive language in health questionnaires and surveys to reduce the risk of excluding gender minority groups. Despite finding very few specific examples of how others have used gender-inclusive language in health questionnaires, many strengths of gender-inclusive language usage were identified.

Generative artificial intelligence in healthcare: current status and future directions

Generative artificial intelligence (GAI) is rapidly transforming the healthcare landscape, offering innovative solutions in areas such as medical imaging, drug discovery, and clinical decision support. This comprehensive review examines the current role of GAI in healthcare, its potential benefits, drawbacks, challenges, and future research directions. By synthesizing recent literature and expert perspectives, this review provides a critical analysis of GAI’s impact on healthcare delivery, patient outcomes, and ethical considerations. While GAI shows promise in enhancing diagnostic accuracy, accelerating drug development, and improving healthcare efficiency, it also faces significant challenges related to data privacy, regulatory compliance, and ethical implementation. This review aims to inform healthcare professionals, researchers, and policymakers about the current state and future potential of GAI in healthcare, emphasizing the need for responsible development and deployment of these technologies.

The Challenges and Risks Brought by AI to the Digital Economy

This article includes study on AI hazards in healthcare and finance, with the goal of exploring the many varieties in this subject. To uncover widespread AI dangers in healthcare, twenty publications were extensively reviewed using selection criteria. This study aims to provide future healthcare researchers and financial institution researchers with a valuable resource for gaining a general understanding of the complex challenges caused by artificial intelligence that may cause something to be placed in healthcare and financial environments. We encourage evidence-based techniques to help other academics handle these difficulties successfully and address the obstacles and hazards connected with artificial intelligence in healthcare by identifying and analyzing these kinds.

Genome Tunisia Project: paving the way for precision medicine in North Africa

BackgroundKey discoveries and innovations in the field of human genetics have led to the foundation of molecular and personalized medicine. Here, we present the Genome Tunisia Project, a two-phased initiative (2022–2035) which aims to deliver the reference sequence of the Tunisian Genome and to support the implementation of personalized medicine in Tunisia, a North African country that represents a central hub of population admixture and human migration between African, European, and Asian populations.The main goal of this initiative is to develop a healthcare system capable of incorporating omics data for use in routine medical practice, enabling medical doctors to better prevent, diagnose, and treat patients.MethodsA multidisciplinary partnership involving Tunisian experts from different institutions has come to discern all requirements that would be of high priority to fulfill the project’s goals. One of the most urgent priorities is to determine the reference sequence of the Tunisian Genome. In addition, extensive situation analysis and revision of the education programs, community awareness, appropriate infrastructure including sequencing platforms and biobanking, as well as ethical and regulatory frameworks, have been undertaken towards building sufficient capacity to integrate personalized medicine into the Tunisian healthcare system.ResultsIn the framework of this project, an ecosystem with all engaged stakeholders has been implemented including healthcare providers, clinicians, researchers, pharmacists, bioinformaticians, industry, policymakers, and advocacy groups. This initiative will also help to reinforce research and innovation capacities in the field of genomics and to strengthen discoverability in the health sector.ConclusionsGenome Tunisia is the first initiative in North Africa that seeks to demonstrate the major impact that can be achieved by Human Genome Projects in low- and middle-income countries to strengthen research and to improve disease management and treatment outcomes, thereby reducing the social and economic burden on healthcare systems. Sharing this experience within the African scientific community is a chance to turn a major challenge into an opportunity for dissemination and outreach. Additional efforts are now being made to advance personalized medicine in patient care by educating consumers and providers, accelerating research and innovation, and supporting necessary changes in policy and regulation.

The Potential of Ambroxol as a Panacea for Neonatal Diseases: A Scoping Review.

Ambroxol, a commonly used mucolytic agent, has been extensively studied for its clinical effectiveness in managing respiratory conditions in pediatric and adult patients. The existing body of research on ambroxol demonstrates its safety and efficacy. However, its potential role in preventing and treating neonatal diseases still needs to be explored. This scoping review aims to shed light on the unexplored potential of ambroxol, particularly its applications in perinatal and neonatal care. We aim to offer valuable insights for healthcare professionals, researchers, and academics, thus presenting a positive perspective. Key scientific databases such as Google Scholar, PubMed, Cochrane Library, and Europe PMC were meticulously searched for relevant literature on ambroxol in perinatal and neonatal medicine. Gray literature was also surveyed, and the search encompassed all study designs and languages up to June 2024. Furthermore, citations and reference lists of relevant articles were scrutinized to identify additional pertinent literature. Ambroxol has demonstrated promising effects in preventing and managing respiratory distress syndrome (RDS). It can enter the placental circulation and rapidly build up in human lung tissue to a much greater extent than in plasma. It promotes fetal lung maturation, surfactant production, and alveolar expansion. Numerous studies have demonstrated the efficacy of antenatal and postnatal ambroxol in the prevention and treatment of RDS. Ambroxol has the potential to be administered intravenously or through nebulization, offering the hopeful possibility of reducing the high failure rate typically associated with non-invasive ventilation in extremely preterm infants, instilling a sense of hope and optimism about the potential of ambroxol. It also shows potential in treating bronchopulmonary dysplasia, meconium aspiration syndrome, and neonatal infections. Ambroxol has been observed to assist in the closure of patent ductus arteriosus in preterm infants by inhibiting vasodilator agents such as nitric oxide and exerting vasoconstrictive properties. However, these biological actions may raise concerns regarding the potential induction of pulmonary hypertension and an increased risk of necrotizing enterocolitis. The present scoping review also examines the clinical evidence and the potential of ambroxol in reducing the incidence of intraventricular hemorrhage in preterm infants. Ambroxol may have potential analgesic properties in managing neonatal pain, and as it can penetrate the blood-brain barrier, it suggests potential neuroprotective properties. These properties may encompass the modulation of microglial activation and the antagonistic impact on glutamate receptors. Ambroxol's attributes could contribute to a decreased susceptibility to neurological complications and have demonstrated anticonvulsant effects in preclinical studies. While low-to-moderate-quality evidence indicates potential applications of ambroxol in neonatal care, further research is needed to determine the drug's optimal dosing, timing, and safety profiles in this patient population. We need to investigate ambroxol's potential synergistic effects with antenatal steroids. Exploration is required to assess ambroxol's potential in reducing the high failure rate associated with non-invasive respiratory support for RDS. Lastly, comprehensive studies on the long-term neurodevelopmental outcomes of neonates exposed to ambroxol are essential.

The experiences of minority language users in health and social care research: A systematic review.

The planning and management of health policy is directly linked to evidence-based research. To obtain the most rigorous results in research it is important to have a representative sample. However, ethnic minorities are often not accounted for in research. Migration, equality, and diversity issues are important priorities which need to be considered by researchers. The aim of this systematic review (SR) is to explore the literature examining the experiences of minority language users in Health and Social Care Research (HSCR). A SR of the literature was conducted. SPIDER framework and Cochrane principles were utilised to conduct the review. Five databases were searched, yielding 5311 papers initially. A SR protocol was developed and published in PROSPERO: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020225114analysis. Following the title and abstract review by two reviewers, 74 papers were included, and a narrative account was provided. Six themes were identified: 1. Disparities in healthcare; 2. Maternal health; 3. Mental health; 4. Methodology in health research; 5. Migrant and minority healthcare; 6. Racial and ethnic gaps in healthcare. Results showed that language barriers (including language proficiency) and cultural barriers still exist in terms of recruitment, possibly effecting the validity of the results. Several papers acknowledged language barriers but did not act to reduce them. Despite research highlighting cultures over the past 40years, there is a need for this to be acknowledged and embedded in the research process. We propose that future research should include details of languages spoken so readers can understand the sample composition to be able to interpret the results in the best way, recognising the significance of culture and language. If language is not considered as a significant aspect of research, the findings of the research cannot be rigorous and therefore the validity is compromised.

Are case reports valuable? Exploring their role in evidence based medicine and patient care

Case reports, often overlooked in evidence-based medicine (EBM), play a pivotal role in healthcare research. They provide unique insights into rare conditions, novel treatments, and adverse effects, serving as valuable educational tools and generating new hypothesis. Despite their limitations in generalizability, case reports contribute significantly to evidence-based practice by offering detailed clinical information and fostering critical thinking among healthcare professionals. By acknowledging their limitations and adhering to reporting guidelines, case reports can contribute significantly to medical knowledge and patient care within the evolving landscape of EBM. This editorial explores the intrinsic value of case reports in EBM and patient care.

Health and Health Care Use of American Indian/Alaska Native Women Veterans: A Scoping Review

BackgroundAmerican Indian/Alaska Native (AI/AN) women serve in the U.S. military, use Veterans Health Administration (VA) health care, and reside in rural areas at the highest rates compared with other women veterans. However, little is known about their unique health care needs, access, and health care use. ObjectiveWe assessed the existing literature on the health and health care use of U.S. AI/AN women veterans. MethodsOnline databases were searched to identify studies. Study characteristics extracted included health care topic, study design, overall sample size and number of AI/AN women veterans, and funding source. We screened 1,508 publications for inclusion; 28 publications were ultimately retained. ResultsHealth care access and use were the most common health care research topics (39%), followed by mental health (36%) and physical health (25%). Few studies considered the impact of rurality. Most studies found significant differences between AI/AN women veterans and other women veterans or AI/AN men veterans. Publication dates ranged from 1998 to 2023, with 71% published after 2010. The majority of studies (75%) were secondary analyses of extant health care data. More than three-quarters of studies (82%) were funded federally (e.g., VA). Many studies were based on VA administrative data, resulting in a gap in knowledge regarding AI/AN women veterans who are not eligible for, or choose not to use, VA health care. ConclusionResearch to inform the health and health care of AI/AN women veterans is limited, especially in terms of known AI/AN and women veterans' prevalent health concerns (e.g., diabetes, hypertension), women's health and reproduction, and how AI/AN women veterans access, use, and confront barriers to health care. Moreover, there is scarce research specific to cultural, tribal, and regional factors that likely affect access and use of particular health care systems or that can affect perspectives on illness that impact long-term treatment adherence and patient outcomes.

Meta-analysis of hybrid immunity to mitigate the risk of Omicron variant reinfection.

Hybrid immunity (a combination of natural and vaccine-induced immunity) provides additional immune protection against the coronavirus disease 2019 (COVID-19) reinfection. Today, people are commonly infected and vaccinated; hence, hybrid immunity is the norm. However, the mitigation of the risk of Omicron variant reinfection by hybrid immunity and the durability of its protection remain uncertain. This meta-analysis aims to explore hybrid immunity to mitigate the risk of Omicron variant reinfection and its protective durability to provide a new evidence-based basis for the development and optimization of immunization strategies and improve the public's awareness and participation in COVID-19 vaccination, especially in vulnerable and at-risk populations. Embase, PubMed, Web of Science, Chinese National Knowledge Infrastructure, and Wanfang databases were searched for publicly available literature up to 10 June 2024. Two researchers independently completed the data extraction and risk of bias assessment and cross-checked each other. The Newcastle-Ottawa Scale assessed the risk of bias in included cohort and case-control studies, while criteria recommended by the Agency for Health Care Research and Quality (AHRQ) evaluated cross-sectional studies. The extracted data were synthesized in an Excel spreadsheet according to the predefined items to be collected. The outcome was Omicron variant reinfection, reported as an Odds Ratio (OR) with its 95% confidence interval (CI) and Protective Effectiveness (PE) with 95% CI. The data were pooled using a random- or fixed-effects model based on the I2 test. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Thirty-three articles were included. Compared with the natural immunity group, the hybrid immunity (booster vaccination) group had the highest level of mitigation in the risk of reinfection (OR = 0.43, 95% CI:0.34-0.56), followed by the complete vaccination group (OR = 0.58, 95% CI:0.45-0.74), and lastly the incomplete vaccination group (OR = 0.64, 95% CI:0.44-0.93). Compared with the complete vaccination-only group, the hybrid immunity (complete vaccination) group mitigated the risk of reinfection by 65% (OR = 0.35, 95% CI:0.27-0.46), and the hybrid immunity (booster vaccination) group mitigated the risk of reinfection by an additional 29% (OR = 0.71, 95% CI:0.61-0.84) compared with the hybrid immunity (complete vaccination) group. The effectiveness of hybrid immunity (incomplete vaccination) in mitigating the risk of reinfection was 37.88% (95% CI, 28.88-46.89%) within 270-364 days, and decreased to 33.23%% (95% CI, 23.80-42.66%) within 365-639 days; whereas, the effectiveness after complete vaccination was 54.36% (95% CI, 50.82-57.90%) within 270-364 days, and the effectiveness of booster vaccination was 73.49% (95% CI, 68.95-78.04%) within 90-119 days. Hybrid immunity was significantly more protective than natural or vaccination-induced immunity, and booster doses were associated with enhanced protection against Omicron. Although its protective effects waned over time, vaccination remains a crucial measure for controlling COVID-19. https://www.crd.york.ac.uk/PROSPERO/, identifier, CRD42024539682.

DDInter 2.0: an enhanced drug interaction resource with expanded data coverage, new interaction types, and improved user interface.

Drug interactions pose significant challenges in clinical practice, potentially leading to adverse drug reactions, reduced efficacy, and even life-threatening consequences. As polypharmacy becomes increasingly common, the risk of harmful drug interactions rises, underscoring the need for comprehensive and user-friendly drug interaction resources to ensure patient safety. To address these concerns and support healthcare professionals in optimizing drug therapy, we present DDInter 2.0, a significantly expanded and enhanced update to our drug interaction database. This new version incorporates additional interaction types, including drug-food interactions (DFIs), drug-disease interactions (DDSIs), and therapeutic duplications, providing a more complete resource for clinical decision-making. The updated database covers 2310 drugs, with 302 516 drug-drug interaction (DDI) records accompanied by 8398 distinct, high-quality mechanism descriptions and management recommendations. DDInter 2.0 also includes 857 DFIs, 8359 DDSIsand 6033 therapeutic duplication records, each supplemented with detailed information and guidance. Furthermore, the enhanced user interface and advanced filtering options in this second release facilitate easy access to and analysis of the comprehensive drug interaction data. By providing healthcare professionals and researchers with a more complete and user-friendly resource, DDInter 2.0 aims to support clinical decision-making and ultimately improve patient outcomes. DDInter 2.0 is freely accessible at https://ddinter2.scbdd.com.

A Concise Review of Qualitative Research Methods in Healthcare Research

A Concise Review of Qualitative Research Methods in Healthcare Research

A Hybrid-Approach for Privacy Preserving Record Linkage - A Case Study from Germany.

Over the last decade, the exponential growth in patient data volume and velocity has transformed it into a valuable resource for researchers. Yet, accessing comprehensive, unique patient data sets remains a challenge, particularly when individuals have received treatments across various practices and hospitals. Traditional record linkage methods fall short in adequately protecting patient privacy in these scenarios. Privacy Preserving Record Linkage (PPRL) offers a solution, employing techniques such as data cryptographic methods to identify common patients occurring in multiple datasets, while maintaining the privacy of other patients. This paper proposes an investigation into combined approaches of two common German PPRL tools, namely E-PIX and MainSEL. Each tool, while aiming for 'privacy preservation', employs distinct methods that offer unique advantages and drawbacks. Our research aims to explore these in a combined approach to leverage their respective strengths and mitigate their limitations. We anticipate that this synergistic approach will not only enhance data privacy but also allow for easier synchronisation of research data. This study is particularly pertinent in light of evolving privacy regulations and the increasing complexity of healthcare data management. By advancing PPRL methodologies, we aim to contribute to more robust, privacy-compliant data analysis practices in healthcare research.

Large Language Models for Synthetic Tabular Health Data: A Benchmark Study.

Synthetic tabular health data plays a crucial role in healthcare research, addressing privacy regulations and the scarcity of publicly available datasets. This is essential for diagnostic and treatment advancements. Among the most promising models are transformer-based Large Language Models (LLMs) and Generative Adversarial Networks (GANs). In this paper, we compare LLM models of the Pythia LLM Scaling Suite with varying model sizes ranging from 14M to 1B, against a reference GAN model (CTGAN). The generated synthetic data are used to train random forest estimators for classification tasks to make predictions on the real-world data. Our findings indicate that as the number of parameters increases, LLM models outperform the reference GAN model. Even the smallest 14M parameter models perform comparably to GANs. Moreover, we observe a positive correlation between the size of the training dataset and model performance. We discuss implications, challenges, and considerations for the real-world usage of LLM models for synthetic tabular data generation.

Synthetic Data Generation in Hematology - Paving the Way for OMOP and FHIR Integration.

This study advances the utility of synthetic study data in hematology, particularly for Acute Myeloid Leukemia (AML), by facilitating its integration into healthcare systems and research platforms through standardization into the Observational Medical Outcomes Partnership (OMOP) and Fast Healthcare Interoperability Resources (FHIR) formats. In our previous work, we addressed the need for high-quality patient data and used CTAB-GAN+ and Normalizing Flow (NFlow) to synthesize data from 1606 patients across four multicenter AML clinical trials. We published the generated synthetic cohorts, that accurately replicate the distributions of key demographic, laboratory, molecular, and cytogenetic variables, alongside patient outcomes, demonstrating high fidelity and usability. The conversion to the OMOP format opens avenues for comparative observational multi-center research by enabling seamless combination with related OMOP datasets, thereby broadening the scope of AML research. Similarly, standardization into FHIR facilitates further developments of applications, e.g. via the SMART-on-FHIR platform, offering realistic test data. This effort aims to foster a more collaborative research environment and facilitate the development of innovative tools and applications in AML care and research.

The Impact of a Lack of Reporting of Sex and Gender in Clinical Research on the Continuum of Medical Education.

Sex and gender impact all areas of health. However, they are not consistently considered in research design. The lack of a sufficient research base regarding the impacts of sex or gender affects the ability to develop health-care professional curricula that include this content for learners across the spectrum of experience. Teaching the importance of sex and gender is critical in training the next generations of health-care professionals and researchers. In addition to improving the current research base, there is a need to raise awareness of this topic among faculty and a need for additional faculty development materials. Learners, clinical faculty, researchers, journal reviewers, and journal leadership all play a role in improving the knowledge base regarding sex and gender and subsequently incorporating this information into curricula.

Advancing Healthcare Research Through Live-Data Integration: Implementing IEEE 11073 and FHIR in Clinical Environment.

The efficient direct integration of real-time medical device data is a promising approach to improve patient care enabling a direct and eminent intervention. This study presents a comprehensive approach for integrating real-time medical device data into clinical environments using the HL7® FHIR® standards and IEEE 11073 Service-Oriented Device Connectivity (SDC). The study proposes a conceptual framework and an opensource proof-of-concept implementation for real-time data integration within the Medical Data Integration Center (MeDIC) at UKSH. Key components include a selective recording mechanism to mitigate storage issues and ensure accurate data capture. Our robust network architecture utilizes Kafka brokers for seamless data transfer in isolated networks. The study demonstrates the selective capturing of real-time data within a clinical setting to enable medical device data for a down-stream processing and analysis.