Informatics Specialists Research Articles

Public Health Informatics in Local and State Health Agencies: An Update From the Public Health Workforce Interests and Needs Survey

Objective:To characterize public health informatics (PHI) specialists and identify the informatics needs of the public health workforce.Design:Cross-sectional study.Setting:US local and state health agencies.Participants:Employees from state health agencies central office (SHA-COs) and local health departments (LHDs) participating in the 2017 Public Health Workforce Interests and Needs Survey (PH WINS). We characterized and compared the job roles for self-reported PHI, “information technology specialist or information system manager” (IT/IS), “public health science” (PHS), and “clinical and laboratory” workers.Main Outcome Measure:Descriptive statistics for demographics, income, education, public health experience, program area, job satisfaction, and workplace environment, as well as data and informatics skills and needs.Results:A total of 17 136 SHA-CO and 26 533 LHD employees participated in the survey. PHI specialist was self-reported as a job role among 1.1% and 0.3% of SHA-CO and LHD employees. The PHI segment most closely resembled PHS employees but had less public health experience and had lower salaries. Overall, fewer than one-third of PHI specialists reported working in an informatics program area, often supporting epidemiology and surveillance, vital records, and communicable disease. Compared with PH WINS 2014, current PHI respondents' satisfaction with their job and workplace environment moved toward more neutral and negative responses, while the IT/IS, PHS, and clinical and laboratory subgroups shifted toward more positive responses. The PHI specialists were less likely than those in IT/IS, PHS, or clinical and laboratory roles to report gaps in needed data and informatics skills.Conclusions:The informatics specialists' role continues to be rare in public health agencies, and those filling that role tend to have less public health experience and be less well compensated than staff in other technically focused positions. Significant data and informatics skills gaps persist among the broader public health workforce.

Implementation of Caregiver Distress Screening

Introduction One area in which high levels of distress among cancer patients is consistently found is the SCT population, with over 50% of patients demonstrating clinically significant levels of distress. Research has also found that caregivers across cancer diseases endorse even higher levels of distress than patients, particularly in SCT population with higher or equal caregiver distress compared to patients’ pre-transplant. The emotional and physical health of the caregiver ineveitably impacts care for the patient, making the measuring and assessing of caregiver distress, particularly in the SCT population, necessary and critical. However, many barriers to caregiver distress screening have been identified in this population. Objectives Successfully and efficiently implement caregiver distress screening at this NCI accredited Cancer Center and assist others in learning challenges that may be encountered and how to address them. Methods Implementation of caregiver screening was met with several barriers including engaging key stakeholders, identifying time point for screening, legal medical concerns for documentation, and workflow of caring for patients and caregivers. Overarching all of these barriers is the utility of the electronic medical record system and its capabilities. Results The first barrier in this process was identifying the key stakeholders. A multi-disciplinary team was created which included physicians, psychologists, nurses, nursing leadership, program administrators, quality coordinator, and informatics specialists. With the multi-disciplinary team came buy-in and distribution of responsibilities in the adaptation of the workflow for caregiver screening. When defining the workflow, a standard screening opportunity presented itself at initial consult and survivorship appointment. Collaborating with internal policy makers, the team obtained approval for documentation of caregiver distress in patient chart with legal medical records. A workflow to have a phone triage for caregiver needs and scheduling was created to allow the caregiver a safe space to self-report desired referrals for self-care. The backdrop to all of these barriers was the limitations and strengths of our electronic medical records (EPIC). The informatics specialists cooperation in this project was a vital component in its implementation. Conclusion Currently the final electronic medical record system requests have been initiated and the plan for implementation is on-going. The project will be piloted in our Bone Marrow Transplant and Hematology ambulatory settings. The pilot will identify additional barriers and these will be addressed as needed. This implementation process will provide a comprehensive distress screening program at this NCI accredited Cancer Center, that also focuses on caregivers.

Tools and processes for tracking IRB approvals as a coordinating center for large multicenter clinical research networks

<p class="abstract"><strong>Background:</strong> Data coordinating centers (DCCs) for multicenter research networks are often responsible for tracking clinical center (CC) IRB approvals. In networks with multiple studies the volume of documentation can be challenging to manage. DCC informatics specialists and coordinators developed simple electronic tools and processes to fulfill this responsibility.</p><p class="abstract"><strong>Methods:</strong> Informatics specialists created a Microsoft Access database to track receipt of IRB approvals from CCs. The database monitors approval expiration dates for an unlimited number of studies and CCs and generates automated reports displaying information on all documented approvals. Coordinators formalized communication procedures for collecting approvals and disseminating information on file. The DCC established a central e-mail account to which CCs submit documentation. The DCC sends monthly e-mails notifying CCs that updated IRB reports have been posted. CCs determine what documentation must be sent to the DCC, and the DCC verifies that all submitted documentation is valid.</p><p class="abstract"><strong>Results:</strong> The database increased DCC efficiencies with a semiautomated mechanism and standardized procedures. New communication processes strengthened compliance with regulatory guidance and client requirements to monitor data collection with appropriate human subjects protections in place. The IRB approval-related e-mail volume sent to CCs was reduced. Automated highlighting of approvals expiring soon reduced DCC coordinator efforts and minimized potential for noncompliance.</p><p class="abstract"><strong>Conclusions: </strong>Although initial investment is needed, formalization of the database and processes result in resource savings throughout the organization’s tenure as a DCC. The flexible nature of access databases makes them an efficient solution for tracking IRB approvals in networks with fluid center compositions.</p>

Requirement Specification and Modeling a Wearable Smart Blanket System for Monitoring Patients in Ambulance.

Background:Nowadays, the role of smart systems and developed tools such as wearable systems for monitoring the patients and controlling their conditions consistently has increased significantly. The present research sought to identify the factors which are essential for designing a wearable smart blanket system and modeling the proposed systems.Methods:To this aim, the requirements for creating the proposed system in ambulance were described after determining the features related to wearable systems by conducting on a comparative study. First, some studies were performed to identify the wearable system development. Then, the elicited questionnaire was given to the physicians and medical informatics specialists. Finally, the extracted requirements were implemented for modeling a smart blanket system.Results:Based on the results, the wearable smart blanket system includes some specific characteristics such as monitoring the important signs, communicating with the surroundings, processing the signals instantly, and storing all important signs. In addition, they should involve some nonfunctional characteristics such as easy installment and function, interactivity, error fault tolerance, low energy consumption, and the accuracy of sign stability. Then, based on the requirements and data elements extracted from the questionnaire, the system was modeled as a detailed design of the proposed technical blanket system. Based on the results, the architecture of the designed system could provide expected scenarios by using the Active Review for Intermediate Design-oriented scenario-based evaluation method.Conclusion:Today, smart systems and tools have considerably developed in terms of monitoring the patients and controlling their conditions. Therefore, wearable systems can be implemented for monitoring the health status of patients in ambulance.

How to Teach Health IT Evaluation: Recommendations for Health IT Evaluation Courses.

Systematic health IT evaluation studies are needed to ensure system quality and safety and to provide the basis for evidence-based health informatics. Well-trained health informatics specialists are required to guarantee that health IT evaluation studies are conducted in accordance with robust standards. Also, policy makers and managers need to appreciate how good evidence is obtained by scientific process and used as an essential justification for policy decisions. In a consensus-based approach with over 80 experts in health IT evaluation, recommendations for the structure, scope and content of health IT evaluation courses on the master or postgraduate level have been developed, supported by a structured analysis of available courses and of available literature. The recommendations comprise 15 mandatory topics and 15 optional topics for a health IT evaluation course.

Inter-institutional Training of Biodiversity Informatics Specialists

This presentation will outline the untapped potential of Information and Library Science (ILS) programs as an integral space for the long-term training and support of biodiversity informatics work. It will also outline the specific proposed steps taken at Indiana University, Bloomington (IU), to provide long-term, systematized training of students focused on information work within this broad domain. As a discipline, ILS has long been preoccupied with the organization, description, curation, and access to a wide variety of information and data sources. ILS curriculum necessarily emphasizes a broad range of information topics given that many different kinds of institutions require these particular skillsets. Typical ILS curriculums focus on topics such as, knowledge organization, metadata, ontologies, database design, scholarly communication, intellectual property, information ethics, interface design, data analytics, online publishing, museum studies, data curation, and collection management/administration. Given this broad range of training, students graduating from ILS programs are perfectly situated to support biodiversity informatics broadly conceived, especially as it relates to the standardization and normalization of data sources across geographically and temporally distributed locations and sources within specific institutional environments. Yet, despite the overlaps between ILS departments, biodiversity informatics, and museum environments, no ILS program has officially taken steps to support this intersectional space. Using concrete examples, this talk will show how the ILS program at IU is building on top of already-existing capacities to more robustly support biodiversity work. The proposed way forward is a tightly integrated approach to biodiversity informatics that integrates theoretical experience and technical training with hands-on internships in museum and biodiversity environments. Through close partnerships with on-campus institutes, such as the Indiana Geological & Water Survey and the Center for Biological Research Collections, as well as larger, external institutions such as the Smithsonian National Museum of Natural History, students will be provided intense fieldwork experience in data management and standards-driven work specific to the museum and biodiversity world. A tiered approach to this training will be suggested, as this kind of training should proceed at both the professional level (for example, master’s level work), as well as more advanced levels focused on more research-driven activity (such as postdoctoral work). Part of this new approach to biodiversity informatics training requires the rearticulation of ILS courses, as well as the addition of new courses that can provide domain-specific knowledge. This presentation, then, will outline a proposed curriculum to support this kind of collaborative training and work. A distributed training structure will be suggested, utilizing expertise from across the globe. In addition, it will show how a more project- and field work-centric approach to ILS education can more quickly and deeply train students to enter the quickly changing field. Part of the difficulty with training biodiversity informatics specialists is that building such programs from the ground up is often costly and requires the building of new workflows and practices. An integrated approach, such as that proposed in this presentation, however, will leverage the respective strengths of ILS program and museum environments in ways that are sustainable and resilient for the long term. The goal here is for institutions to support each other in ways that strengthen their core missions, as well as push the discipline forward in systematic and unique ways.

Terminology, units and reporting - how harmonized do we need to be?

Harmonization initiatives in laboratory medicine seek to eliminate or reduce illogical variations in service to patients, clinicians and other healthcare professionals. Significant effort will be required to achieve consistent application of terminology, units and reporting across laboratory testing providers. Current variations in practice for nomenclature, reference intervals, flagging, units, standardization and traceability between analytical methods, and presentation of cumulative result data are inefficient and inconvenient, or worse yet, patient safety risks. All aspects of laboratory service across the "total testing process" ultimately depend on concise, reliable communication. Clinical terminologies (e.g. SNOMED-CT, LOINC, IFCC/IUPAC NPU) provide a mechanism to correctly identify an analyte or panel of tests within a request for testing and communicate the results back to the clinician or electronic health record (EHR). Electronic systems for requesting and reporting laboratory testing are said to be interoperable when reliable connection and communication of content occur. Modern electronic reports and EHRs will provide greater flexibility and functionality, but also require effective guidelines or standards to ensure consistent representation of laboratory data. Programs to harmonize service in these areas require ongoing local, national and international efforts and should incorporate stakeholders from laboratories, medical staff, information technology and informatics specialists, patient representatives and government. The process of identifying harmonized best practice, then ensuring uptake across many laboratory testing providers, is generally iterative rather than "one off". New opportunities for additional harmonization will be generated as analytical performance, standardization and traceability, and diagnosis and treatment continue to evolve.

TaxonWorks

TaxonWorks (http://taxonworks.org) is an integrated workbench for taxonomists and biodiversity scientists. It is designed to capture, organize, and enrich data, share and refine it with collaborators, and package it for analysis and publication. It is based on PostgreSQL (database) and the Ruby-on-Rails programming language and framework for developing web applications (https://github.com/SpeciesFileGroup/taxonworks). The TaxonWorks community is built around an open software ecosystem that facilitates participation at many levels. TaxonWorks is designed to serve both researchers who create and curate the data, as well as technical users, such as programmers and informatics specialists, who act as data consumers. TaxonWorks provides researchers with robust, user friendly interfaces based on well thought out customized workflows for efficient and validated data entry. It provides technical users database access through an application programming interface (API) that serves data in JSON format. The data model includes coverage for nearly all classes of data recorded in modern taxonomic treatments primary studies of biodiversity, including nomenclature, bibliography, specimens and collecting events, phylogenetic matrices and species descriptions, etc. The nomenclatural classes are based on the NOMEN ontology (https://github.com/SpeciesFileGroup/nomen).

Criteria for assessing the quality of mHealth apps: a systematic review.

Review the existing studies including an assessment tool/method to assess the quality of mHealth apps; extract their criteria; and provide a classification of the collected criteria. In accordance with the PRISMA statement, a literature search was conducted in MEDLINE, EMBase, ISI and Scopus for English language citations published from January 1, 2008 to December 22, 2016 for studies including tools or methods for quality assessment of mHealth apps. Two researchers screened the titles and abstracts of all retrieved citations against the inclusion and exclusion criteria. The full text of relevant papers was then individually examined by the same researchers. A senior researcher resolved eventual disagreements and confirmed the relevance of all included papers. The authors, date of publication, subject fields of target mHealth apps, development method, and assessment criteria were extracted from each paper. The extracted assessment criteria were then reviewed, compared, and classified by an expert panel of two medical informatics specialists and two health information management specialists. Twenty-three papers were included in the review. Thirty-eight main classes of assessment criteria were identified. These were reorganized by expert panel into 7 main classes (Design, Information/Content, Usability, Functionality, Ethical Issues, Security and Privacy, and User-perceived value) with 37 sub-classes of criteria. There is a wide heterogeneity in assessment criteria for mHealth apps. It is necessary to define the exact meanings and degree of distinctness of each criterion. This will help to improve the existing tools and may lead to achieve a better comprehensive mHealth app assessment tool.

Evaluating satisfaction of patients with stutter regarding the tele-speech therapy method and infrastructure

ObjectiveInvestigating the required infrastructure for the implementation of telemedicine and the satisfaction of target groups improves the acceptance of this technology and facilitates the delivery of healthcare services. The aim of this study was to assess the satisfaction of patients with stutter concerning the therapeutic method and the infrastructure used to receive tele-speech therapy services. MethodsThis descriptive-analytical study was conducted on all patients with stutter aged between 14 and 39 years at Jahrom Social Welfare Bureau (n = 30). The patients underwent speech therapy sessions through video conferencing with Skype. Data were collected by a researcher-made questionnaire. Its content validity was confirmed by three medical informatics specialists. Data were analyzed using SPSS version 19. ResultsThe mean and standard deviation of patient satisfaction scores concerning the infrastructure and the tele-speech therapy method were 3.15 ± 0.52 and 3.49 ± 0.52, respectively. No significant relationship was found between the patients satisfaction and their gender, education level and age (p > 0.05). The results of this study showed that the number of speech therapy sessions did not affect the overall satisfaction of the patients (p > 0.05), but the number of therapeutic sessions had a direct relationship with their satisfaction with the infrastructure used for tele-speech therapy (p < 0.05). ConclusionsThe present study showed that patients were satisfied with tele-speech therapy. According to most patients the low speed of the Internet connection in the country was a major challenge for receiving tele-speech therapy. The results suggest that healthcare planner and policy makers invest on increasing bandwidth to improve the success rate of telemedicine programs.

THE RIGHT BALANCE BETWEEN TECHNOLOGY AND PATIENT CARE

In today's healthcare system, information technology is the foundation of the future. Healthcare modernization is best visualized if we compare how we were thirty years ago and where we are today. The need for improvement was the driving force behind the evolution of computers in healthcare. The majority of the past thirty years of technological expansion was spent on computer programs for administrative purposes while the past decade has seen as emphasis on the clinical process. Patient care has become a primary focus in the development of new concepts and knowledge in healthcare technology. Technological development in clinical applications is the current trend in healthcare and it will continue to play a major role for years to come. This article will describe the participation of nurse informatics specialists in adopting the right balance between the electronic documentation in nursing workflow and quality of patient care.

Analiza potreba zaposlovnim informatičarima na tržištu radne snage Srbije

The main subject of the paper is the analysis of the needs for business informatics specialists at the labor market of Serbia. The analysis was conducted by collecting data from both relevant national sources (National Employment Service, Statistical Office of the Republic of Serbia and others) and international sources (Eurostat, World Economic Forum and others). One part of the analysis was based on the data collected from the survey conducted by the authors of the paper at the Faculty of Economics, University of Belgrade. The essential part of the survey was focused on the interest of students at the first year of studies for the new module called Business informatics. One of the main conclusions of the analysis is that the business component of IT is becoming more popular with growing demand. Therefore, changes in the field of higher education concerning business informatics programs are necessary in order to fulfill demand at the Serbian labor market. Finally, it was revealed that the number of companies involved in the development of business software has lately significantly increased in Serbia. These companies have an additional need for a substantial number of IT professionals who have both high economic (business) and IT education.

Determining attitude and readiness of Medical students in Kerman University of Medical Sciences concerning acceptance of Decision Support Systems for Electronic Prescription in 2017

Introduction: Clinical Decision Support Systems (CDSS) are any computer program designed to assist health care professionals in making clinical decisions, especially at the moment of action. These information systems are flexible and interactive, helping people by making use of models and rules of a comprehensive database, or on the basis of clinical guidelines, to make applicable decisions, especially solving difficult problems with common scientific methods. Therefore, these systems support complex medical decisions, increase their effectiveness, and can lead to a reduction in the types of medical errors, such as medication errors. However, knowledge and attitude of the future physicians in the country about these systems is unclear. The purpose of this study was Determining attitude and readiness of Medical students concerning acceptance of Decision Support Systems for Electronic Prescription.&#x0D; Methods: This research is descriptive-analytic. The research population included general medical students of Kerman University of Medical Sciences in 2017. Out of these students, a sample of 226 people was selected by proportional sampling. Data collection was done using a standard questionnaire. The questionnaire was first translated into Persian and then its validity was confirmed by three medical informatics specialists. Data analysis was done descriptively-analytically using SPSS 19.&#x0D; Results: The findings of this study showed that 17% of students (n=36) knew about this system and how to use it, and 83% of them (n=177) were willing to learn and use this system to practice their profession in the future. More than half of them (n=121) believed that using this system would Reduce errors in prescribing. 80% of them (n=170) lacked a strategic plan to implement a decision support system for electronic prescription and a lack of standard and acceptable software, and about 60% (n=128) lack of financial incentives and lack of sufficient evidence Concerned about the usefulness of using it as a potential obstacle to the implementation of this system. There was no significant difference between the age, sex and term of the students with their familiarity with this system (P&gt;0.05).&#x0D; Conclusion: The results of this study showed that while many students lack sufficient knowledge about the clinical decision support system, they are interested in learning and using it, especially in the field of prescribing drugs. This result indicates that the system is likely to be admitted if it is implemented and educated to medical students and doctors.

Attitude and readiness of Dentistry students in Kerman University of Medical Sciences concerning Tele-dentistry in 2017

Introduction: Tele-dentistry is the use of information and telecommunications technology for dental care, counseling, education and public awareness in the same way as remote medical. Tele-dentistry is a relatively new field that can change the dental care system. However, many dentists are unaware of the goals, benefits, and how to participate. Therefore, this study was conducted to determine the knowledge and attitude of dental students regarding telemedicine.&#x0D; Methods:The present study is descriptive-analytic. The study population consisted of all dental students in Kerman in year 2017 and sample of 230 students selected by proportional sampling. For data collection, a complete English translation of an English-language article in the Journal of Clinical and Diagnostic Research, whose validity was confirmed by three of the leading medical informatics specialists in English, was then used to analyze the data using the software SPSS 19.&#x0D; Results: The findings of this study showed that there is no significant difference between the students' age, sex and term of education with their knowledge of tele-dentistry (P&gt;0.05). Knowledge and attitude of 72% of students in tele-dentistry is very low. 40% of them said tele-dentistry would be very beneficial and more than half of them would be willing to do tele-dentistry in the future. 81% of them agreed that tele-dentistry could be a good tool for health education and oral health, and effective in educating the health of a large number of people. 75% of them felt that distance dental care saves time, and 81% of students believed that tele-dentistry was not financially feasible.&#x0D; Conclusion: The results of this study showed that many respondents lacked adequate knowledge and knowledge about tele-dentistry. Hence, there is a huge need for awareness among dentists to further the future of dentistry in the future. Therefore, it is suggested that the related institutions take more serious measures for awareness and education about tele-dentistry for students.

The Content of Professional Training of Future Informatics Specialists in Kazakhstan: Process of Developing Educational Program

The article focuses on the training of future informatics specialists in higher education system of Kazakhstan. The prelude to the change in the educational program, analysis of Competence was described, Competence was analyzed and the competence-based model of the informatics specialist was built for Kazakhstan. An educational program has been developed on the basis of this model that includes requirements not only of normative documents, but also of other customers (employers, IT professionals). The development of industry in Kazakhstan gave rise to the inclusion of the industrial and engineering areas into the program, that will allow students in the future to access employment in the industrial sector of the economy of Kazakhstan.

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OBJECTIVES/SPECIFIC AIMS: The primary objective of this effort is to develop and distribute an easy to use i2b2 component that is capable of evaluating diverse complex relationships for a wide variety of exposures and outcomes over time. In this manner we are able to leverage the unique design of the i2b2 database to support health services research, comparative effectiveness, and quality improvement using a single tool. Furthermore, our novel database redesign has the potential to provide user-friendly access to individual and group CHC data for CER. METHODS/STUDY POPULATION: For this project we used software experts, clinical informatics specialists, and the existing i2b2 open-source software to convert our legacy HOME Cell into a web-client version. The tool will be used to study health outcomes within a network of Boston based Community Health Centers and the largest safety-net hospital in New England, Boston Medical Center. RESULTS/ANTICIPATED RESULTS: The new web-client HOME Cell will allow i2b2 users to model virtually any exposure (including therapeutic interventions such as medications or tests) in i2b2 against any outcome accounting for complex temporal relationships and other factors. In addition we plan to use our new Community Health Center views to enhance our community engagement activities by allowing direct access to their data for our partners. DISCUSSION/SIGNIFICANCE OF IMPACT: Our project addresses multiple national priorities related to data sharing, clinical research informatics, and comparative effectiveness. The web-client version of the HOME Cell substantially improves our community’s access to HOME Cell functionality and is a novel, sharable resource for use within the CTSA/NCATS community. Our approach provides a new way to perform large-scale collaborative research without the need to actually move patient-level data and has demonstrated that CER, health services research, and quality measurement can share a common framework. In addition, and as demonstrated in our earlier pilot work, the HOME Cell also has the potential to support large-scale multivariate analyses in a distributed manner that does not require sharing of patient-level data. We believe our approach has great promise for supporting the reuse of clinical data for rapid, transparent, health outcome assessments on a national scale. Our efforts support multiple strategic goals including: (1) support for building national clinical and translational research capacity by enhancing a broadly adopted informatics tool (i2b2); (2) enhanced consortium-wide collaborations by offering a tool that can be easily shared within the CTSA network to support multi-institutional collaboration; and (3) improving the health of our communities by offering a tool that has the potential to provide new insights into health care processes and outcomes that could drive innovation and improvement activities.

Discovering Nature in the City with a Citizen Science Mobile App

In the project "Stadtnatur entdecken" (discovering nature in the city) a multidisciplinary team of specialists in biology, informatics, urban ecology and social sciences is looking into how to effectively communicate educational content on environmental topics to young adults and to allow them to contribute as citizen scientists. The mobile app "Naturblick" presents on experience of nature in an urban setting. Several tools are combined in the app that allows users to identify species. The team developed auditory and visual pattern recognition tools that will automatically identify sound recordings and photographs and multi-access identification keys for flora and fauna. There is a map function that will help explore nature in the users’ immediate vicinity in Berlin, Germany, highlighting the diversity of species to be found. Users are able to share their observations and records. The project is designed to involve user participation and continuous improvement based on user feedback of both the content and technology.

Application of triangulation approach in requirements engineering process: A study in analysis and design of the pediatrics epilepsy information system

: Introduction: Requirements Engineering process is a crucial phase in software development. In order to achieve a successful design of health information systems (HISs), applying the best methodologies is essential. Therefore, the aim of the present study was to design pediatrics Epilepsy Information System (EPIS) as well as the use of triangulation approach in elicitation and validation of epilepsy information system requirements in its engineering process. Methods: This applied study was carried out in Bandar Abbas pediatric hospital. Triangulation approach based on three different analyses and validation methods in requirements engineering process was applied. To do the triangulation work, as well as designing a usable system, according to the most common User Centered Design (UCD) methods, we use three well-known methodological approaches in UCD: (a) Object-Oriented System Analysis (OOSA); (b) Hierarchical Task Analysis; and, (c) Prototyping. The results of each of these methods were analyzed by selected clinical staff, iterative cycle in models design also continued until lack of need for new changes. Then final results were presented in a general category in the form of triangulation matrix. Results: 55 high-level requirements with minimum information items to store information of hospitalized epileptic patients obtained from multiple methods. The greatest requirements (84%) were identified or validated in the OOSA step, some requirements (13%) have been identified only in the design and evaluation of prototype. Conclusion: Triangulation approach helped us in confirmation of findings, and finally enhance the credibility of the study. Health informatics specialists should try to use of multiple methods in the early phases of systems design that lead to a rich and comprehensive picture of HIS requirements.

Introducing the PRIDAL model for linking routine health and identifiable patient reported questionnaire data

ABSTRACTObjectives&#x0D; &#x0D; To present an efficient privacy-protecting model (PRIDAL) for linking routine and identifiable patient-reported research data.&#x0D; To describe the application of the PRIDAL model with within a major portfolio trial linking a range of health and demographic datasets pertaining to &gt;230,000 patients, alongside &gt;2,300 questionnaires.&#x0D; To summarise the lessons learned from the application of the PRIDAL model.&#x0D; &#x0D; ApproachThe rise in availability, quality and use of routine health data has resulted in well-developed methods for anonymised linkage of data from multiple sources. However methods for combining identifiable data (e.g. patient-reported questionnaires) with routine anonymised data are not yet tried and tested. Linking these data presents opportunities to improve the feasibility and effectiveness of observational and experimental studies, but emerging data linkage processes must address the appropriate balance between data security and usability. The Process for Routine and Identifiable Data Linkage (PRIDAL) was devised to efficiently link routine hospital data and patient-reported quality of life and quality of care questionnaire data as part of the PRISMATIC trial (http://www.trialsjournal.com/content/14/1/301). This is a mixed methods progressive cluster randomised trial of the efficacy of an emergency admission risk prediction tool in primary care, funded by the NIHR HS&amp;DR programme. PRIDAL was conceived by a group of specialists in e-trials, health informatics, information governance and process mapping who reviewed data sources, flows, owners, and security to develop a practical and intuitive process model.&#x0D; ResultsWe will present the PRIDAL process model and describe its application in relation to the PRISMATIC study. We will demonstrate that the model achieves high data matching rates (&gt;99%), and consider the lessons learnt from its application.&#x0D; ConclusionsThe linking of routine health and patient self-reported data presents a valuable opportunity in health research, but clear, replicable models, are needed to support ethical and practical data linkage. We present the fully tested PRIDAL model as a potential solution.

Interactive design of patient-oriented video-games for rehabilitation: concept and application

Purpose: Serious video-games are innovative tools used to train the motor skills of subjects affected by neurological disorders. They are often developed to train a specific type of patients and the rules of the game are standardly defined. A system that allows the therapist to design highly patient-oriented video-games, without specific informatics skills, is proposed.Method: The system consists of one personal computer, two screens, a Kinect™ sensor and a specific software developed here for the design of the video-games. It was tested with the collaboration of three therapists and six patients, and two questionnaires were filled in by each patient to evaluate the appreciation of the rehabilitative sessions.Results: The therapists learned easily how to use the system, and no serious difficulties were encountered by the patients. The questionnaires showed an overall good satisfaction by the patients and highlighted the key-role of the therapist in involving the patients during the rehabilitative session.Conclusions: It was found that the proposed system is effective for developing patient-oriented video-games for rehabilitation. The two main advantages are that the therapist is allowed to (i) develop personalized video-games without informatics skills and (ii) adapt the game settings to patients affected by different pathologies.Implications for rehabilitationVirtual reality and serious video games offer the opportunity to transform the traditional therapy into a more pleasant experience, allowing patients to train their motor and cognitive skills.Both the therapists and the patients should be involved in the development of rehabilitative solutions to be highly patient-oriented.A system for the design of rehabilitative games by the therapist is described and the feedback of three therapists and six patients is reported.