Healthcare Information Management Research Articles

Design Theory for Societal Digital Transformation: The Case of Digital Global Health

With societal challenges, including but not limited to human development, equity, social justice, and climate change, societal-level digital transformation (SDT) is of imminent relevance and theoretical interest. While building on local-level efforts, societal-level transformation is a nonlinear extension of the local level. Unfortunately, academic discourse on digital transformation has largely left SDT unaccounted for. Drawing on more than 25 years of intensive, interventionist research engagement with the digital transformation of public healthcare information management and delivery in more than 80 countries in the Global South, we contribute to theorizing SDT in the form of a design theory consisting of six interconnected design principles. These design principles articulate the interplay and tensions of accommodating over time increased diversity and flexibility in digital solutions, while simultaneously connecting local, national, and regional/ global efforts.

Identifying the Knowledge Structure and Trends of Nursing Informatics: A Text Network Analysis.

With the advent of the information age and technological development, the importance of digital health technologies has increased. Subsequently, nursing informatics has been developed to enhance the effectiveness of healthcare information management and communication. This study aimed to identify the nursing informatics knowledge structure and research trends through quantitative analysis using text network analysis. Here, we analyzed 14 225 studies published by 2020. The knowledge structure of nursing informatics and changes therein were clarified by identifying and analyzing the core keywords, topics, and changes in the topics of related studies over time. We identified "patient," "health," "system," and "information" as core keywords connecting other keywords. Over time, the networks between "information," "communication," and "technology" strengthened, and "patient safety" and "quality" have recently emerged as research keywords. This change indicates an increase in the importance of nursing education on technology. Similar changes appeared in the topic analysis, showing an increased proportion of research related to system and technology and nursing education. These results can broaden a systematic understanding of nursing informatics research. Furthermore, given these findings, the importance of nursing informatics on patient safety and nursing education-based on the development of systems and technology-can be expected to continue growing.

Respect for patients’ rights in health facilities: experiences of patients during the early period of the COVID-19 pandemic in Ghana

PurposeThis paper aims to identify human rights violations of patients during the early periods of the COVID-19 pandemic in Ghana by investigating the experiences of people on how health-care professionals discharged their responsibilities during the time in question.Design/methodology/approachExplanatory design of the mixed methods approach was adopted, with the intention of collecting both quantitative and qualitative data sequentially, and then integrating the results at the interpretation stage. The approach enriched the quality of data collected as it offered the advantage of shedding light on the primary motivations and reasons for attitudes and behaviours and helped to provide an in-depth understanding of how individuals interpret the happenings around them and their experiences. Thus, although some amount of quantitative method was used in the data collection, the core of this paper is based on the qualitative interpretations.FindingsThe study reveals that health-care professionals, especially those in the Tema Metropolis, undermined certain fundamental human rights of patients during the early period of the COVID-19 pandemic. This includes failure to provide information to patients about treatment options and potential risks of medications; failure to seek the informed consent of patients before performing medical procedures; denial of access to medical files of patients for transfer; and inability or failure to provide medical ambulances services to patients on time.Originality/valueAlthough many publications on human rights dimensions and health protective issues on COVID-19 pandemic are available on a global scale, still little information pertaining to experiences of individuals with health-care professionals during the early days of the COVID-19 pandemic, especially in Ghana through the lens of patient’s rights exists. This paper, therefore, fills an important gap in health-care management information, critical for policy decision-making processes regarding patient’s rights in times of pandemic control.

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.

Theoretical and practical applications of blockchain in healthcare information management

A primary objective of blockchain technology is to address information security and efficiency issues related to existing information sharing systems. For the sharing of health records, little is known about the application of blockchain in management information systems. There are strict regulations for sharing health information due to insecure systems and privacy concerns. To significantly and effectively improve medical diagnosis, it is beneficial to have efficient, reliable, and accurate accessibility to a patient's full medical history. Due to concerns with the security of health systems and privacy concerns, medical histories are not always accessible to healthcare providers. To help increase accessibility options, this research proposes a blockchain-based model that facilitates sharing medical records in a manner that is beneficial to both healthcare providers and patients. Social exchange theory provides the theoretical support for the conceptual model presented. Experimental findings based on 151 participants revealed that the blockchain technology can provide a secure information system and increase patient motivation to share medical records. To show the applicability of the proposed use of blockchain from a practical managerial perspective, we show feasibility by developing an Android software application.

Main directions of the improvement of healthcare information and communication management in the conditions of utc in the post-war period

The paper is devoted to the important problem of determining the directions of improving the management of the information and communication component of health care in the context of administrative-territorial reform, for example, united territorial communities. The problems of forecasting social contradictions and organization of relations in these conditions in the post-war period are studied. Possible measures for organized confrontation of crisis phenomena provoked by the conflict situation, by introducing modern information and communication support as a mean of regulating economic activity in the state, are considered. Measures to ensure effective consideration of applications and complaints and the impact on the quality of UTC medical care, prevention of negative consequences are proposed. The practical value of the research results on this topic is marked. It consists in the wide possibilities of using scientific developments and proposals and in particular the organizational and economic mechanism for state regulation of the national economy in the post-war period and improving the management of social and labour relations. functioning in the period of restoration of the post-war sphere of services. The author's approach to the investigation of theoretical and practical aspects of management of information and communication component of health care institutions in the administrative-territorial reform on the example of communication support of functional activities of medical institutions of united territorial communities, thus making more coordinated socio-humanitarian development of UTC economy is presented. The correspondence of the research topic to the current problem in accordance with the directions of implementation of the modern social economy and policy in Ukraine in accordance with the European integration processes is determined. It is investigated that the practical implementation of the obtained results consists in wide possibilities of using the developments to improve the quality of information and communication services by health care institutions, the development of advertising and strengthening the stability of UTC.

A Usability Management Framework for Securing Healthcare Information System

Transformation from conventional business management systems to smart digital systems is a recurrent trend in the current era. This has led to digital revolution, and in this context, the hardwired technologies in the software industry play a significant role However, from the beginning, software security remains a serious issue for all levels of stakeholders. Software vulnerabilities lead to intrusions that cause data breaches and result in disclosure of sensitive data, compromising the organizations’ reputation that translates into, financial losses and compromising software usability as well. Most of the data breaches are financially motivated, especially in the healthcare sector. The cyber invaders continuously penetrate the E- Health data because of the high cost of the data on the dark web. Therefore, security assessment of healthcare web-based applications demands immediate intervention mechanisms to weed out the threats of cyber-attacks for the sake of software usability. The proposed disclosure is a unique process of three phases that are combined by researchers in order to produce and manage usability management framework for healthcare information system. In this most threatened time of digital era where, Healthcare data industry has borne the brunt of the highest number of data breach episodes in the last few years. The key reason for this is attributed to the sensitivity of healthcare data and the high costs entailed in trading the data over the dark web. Hence, usability management of healthcare information systems is the need of hour as to identify the vulnerabilities and provide preventive measures as a shield against the breaches. The proposed unique developed model of usability management workflow is prepared by associating steps like learn; analyze and manage. All these steps gives an all in one package for the healthcare information management industry because there is no systematic model available which associate identification to implementation steps with different evaluation steps.

Using Blockchain Integration Patterns to Ensure Data Integrity in the Health Care Industry

Security is crucial in the healthcare industry. Between 2012 and 2019, almost 179 million health records were exposed to data breaches. The intruders got into homes and companies to take credit card and banking information, as well as health and genetic research data. Blockchain is a fantastic technology for applications in the area of protection because it can keep an incorruptible, decentralized, and open record of all patient data. It is, nevertheless, secure and keeps any person's identity hidden. When dealing with decentralized technology, patients, doctors, and hospital personnel may all share the same information. On a blockchain, the cost of verifying a single transaction is negligible. You can audit a single piece of data in real time, and it's entirely visible to everyone. As a result, costless verification is economically possible. Recent audits of healthcare data, for example, have necessitated the time-consuming and costly examination of tiny units of transactions. This procedure had to be interrupted and redone on a frequent basis prior to blockchains in order to comply with regulations. Compared to traditional healthcare information management solutions, blockchain provides five potential benefits. Blockchains are ideal for decentralized administration applications, such as when hospitals, consumers, and payers want to work together without the need for a middleman. The second advantage of blockchains is that they may offer immutable archives of sensitive data, which makes them ideal for static databases (e.g., insurance claim records). Blockchains are very useful for tracing the origins and histories of digital artifacts (e.g., patient consent in clinical trials). According to cryptographic protocols, changing the ownership of an item can only be done by the person who owns it. Furthermore, the attributes' origins may be traced, making previously confirmed evidence considerably more reusable. The fourth advantage of blockchains is that they ensure the longevity, consistency, and accessibility of records. As a result, they're perfect for long-term records storage and availability (e.g., the electronic health records of patients). Patients' personal keys encrypt the data, which is only accessible with their consent, making it safer and more private. There is no method to access personal information even if the network is hacked by a hostile entity.

Client information systems’ support for case-based social work: experiences of Finnish social workers

ABSTRACT In recent years, Finland has seen extensive development in the area of social and healthcare information management aimed at harmonizing client information systems (CISs) and ways of documenting client information. The developments aim to support the utilization of recorded information at different levels of service systems, including the level of social work practice. This article investigates the relationship between social work practice and the use of CISs by answering the following question: To what extent do CISs support case-based social work in Finland? Social work is approached as a knowledge-intensive practice in which CISs have become increasingly important for managing case work. The research question is considered in relation to recent national developments in social and healthcare information management. The study uses survey data from a subpopulation of social workers (n = 309) working in municipal social services and combines quantitative and qualitative data. The findings reveal that current CISs do not offer sufficient support for case-based social work. Although CISs serve reasonably well for storing and documenting case-based information, they generally serve social workers poorly in terms of providing them with the tools they need to understand cases in their entirety and form comprehensive knowledge for their practice. To provide adequate CISs that support case-based social work, it is necessary to see social workers as active users of information and understand the role of CISs in the knowledge formation process in social work.

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.

Literature review on Health Knowledge Management in the last 10 years (2009-2019)

Health care institutions (HCI in further text) are in constant interplay with their context, generating ensuing opportunities and threats. Knowledge management has been paramount when it comes to integrating state-of-art technologies in order to improve system efficiency and decision processes in hospital management outputs. Thus, it is pivotal to explain the role of knowledge management in hospital management. Research of peer-reviewed articles published from 2009 to 2019, and obtained via the Scopus database, was carried out based on two key subjects, ‘knowledge management’ and ‘health care institutions’. The research was performed through a descriptive, quantitative and qualitative analysis of the most cited 47 scientific articles found in the SCOPUS database. We conclude that 'knowledge management' (KM in further text) has become an important research area in terms of HCI management. The article identifies the central themes in KM research in HCI. However, the area on KM literature is highly fragmented, requiring development. Based on an analysis of the collected literature, we identified the key research themes and resulting development patterns, namely, the integration and interoperability of knowledge from different sources into a single platform, occupational safety, the need to ascertain quality and pertinent information among general web information, culture and social behaviour and data security. We posit that KM effectively facilitates the utilization of healthcare information resources and management decision making in hospitals.

Abstract OT-07-01: Guardant360® related clinical outcomes in patients who share medical records-breast cancer (GRECO-B)

Abstract Background: Cell free circulating tumor DNA (ctDNA) is a proven viable alternative to tissue molecular profiling with high sensitivity, specificity, and positive predictive value. However, there is limited data on the overall outcomes of patients following ctDNA testing. Guardant360® Related Clinical Outcomes in Patients who Share Medical Records - Breast Cancer (GRECO-Breast) is a novel, patient-centric approach to evaluate clinical data and outcomes. This real-world prospective observational study intends to assess the health outcomes of patients with advanced breast cancer who have undergone Guardant360 ctDNA testing by consenting patients through siteless methodologies to share their medical records and imaging studies documenting their clinical history. Trial design: This is an observational study to be conducted in the United States. Patients with a diagnosis of breast cancer and a completed Guardant360 test will consent to share their medical records. Patients will be recruited by telephone or email to determine interest in the study. Should patients be interested in contributing to this study, they will be asked to consent via an electronic signature platform (e-signature) and electronic informed consent form (e-consent). Enrolled participants will be required to sign an electronic medical records release form for data review and verification by the study team. A healthcare information management organization will abstract participant demographics, cancer-related therapies, and clinical outcomes directly from source data for final analysis. Eligibility criteria: Prospective participants will be adults (age 18+) with a diagnosis of breast cancer with a completed Guardant360 test who consent to be enrolled in the study. Endpoints: Primary endpoint: To measure event free survival (EFS, composite endpoint of overall survival, progression events, and subjects lost to follow-up) stratified by treatment and genomic biomarker. Secondary endpoints: 1) Assess the rate of biomarker discovery compared to tissue genotyping results, when available; 2) Time to Next Treatment (TTNT); 3) Real-world Time to Tumor Progression (rwTTP); defined and documented either clinically or radiologically 4) Real-world Overall Survival (rwOS); defined as either clinically recorded death or secondary validated sources; 5) Record completeness of data and data quality. Statistical methods: Descriptive statistics will be used to characterize the patient population. These will include frequency distributions, cross tabulations, and summary measures such as means, standard deviations, and ranges. Graphical displays will be employed, where appropriate, such as box plots, scatter plots, and survival curves for time-to-event endpoints. Present accrual and target accrual: GRECO-Breast opened for enrollment in June 2020 with a goal of enrolling up to 300 participants. Contact information: For more information, please visit: https://clinicaltrials.gov/ct2/show/NCT04436393 Citation Format: Aaron Fuchs, Matthew Muia, Vicky Ho, Kristi Ashton, Naveen Kumar, Enrique Marino, Junhua Yu, Kathryn Lang, Victoria M Raymond. Guardant360® related clinical outcomes in patients who share medical records-breast cancer (GRECO-B) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr OT-07-01.

HOCBS: A privacy-preserving blockchain framework for healthcare data leveraging an on-chain and off-chain system design

In the context of blockchain technology, “off-chain” refers to computation or data that is structurally external to the blockchain network. Off-Chain Blockchain Systems (OCBS) enable this information processing and management through distributed software architecture where the blockchain network interacts with off-chain resources. Hence, OCBS are a critical data governance component in the design of enterprise blockchain solutions, resulting in extensive research and development exploring the interplay between on-chain and off-chain storage and computation and efforts to evaluate their performance relative to other information management systems. Key features of OCBS’ are their ability to improve scalability, reduce data storage requirements, and enhance data privacy, all extremely critical issues to enable broader blockchain adoption. These OCBS features map well to the needs of the healthcare industry, particularly due to the need to manage various types of medical, consumer, and other health-related data. However, different types of health data are also subject to stringent regulatory, security and legal requirements, a key factor limiting blockchain adoption in the sector. In response, there is a critical need to better align OCBS design features to different types of healthcare data management and their respective governance and privacy regimes. This article first reviews the characteristics of different constructs of OCBS. It then proposes a modular hybrid privacy-preserving framework leveraging off-chain and on-chain blockchain system design applied to three different reference models that illustrate how blockchain can enhance healthcare information management. Through this privacy-preserving framework we hope to liberate healthcare data by enabling sharing, sovereignty and enhanced trust.

Hematology Patient Protection During the COVID-19 Pandemic in Italy: A Nationwide Nursing Survey.

BackgroundItaly has been one of the first European countries hit by the COVID-19 pandemic, with many patients dying from severe respiratory issues, especially frail subjects. Hematology patients are generally thought to be at high risk of developing severe COVID-19-associated complications. The aim of this work was to describe the infection control measures adopted in Italian hematology settings to protect patients and health-care professionals.Materials and MethodsOn behalf of the Nursing Campus in Hematology Group, a nationwide nursing survey was conducted. Questionnaire items included general information, infection control measures, patient and health-care professional protection, information management, and participants’ opinion on critical issues. Data have been analyzed by center location (Northern, Central, or Southern Italy) and by patient age (adult vs pediatric).ResultsForty-four Italian hematology centers participated, representing 52.4% of those invited. Patients underwent nasopharyngeal swabs (93.2%) generally the day before admission (43.2%), though less frequently in Southern centers (p = 0.0377). Visitor restrictions were implemented in all centers: 65.9% barred all visitors, while 25.0% allowed visitors only for patients with specific conditions, especially in Central Italy. Deficiency of personal protective equipment, including masks (45.5%) and gloves (22.7%), was reported, although the nurses’ opinion was that the emergency was nevertheless well managed to protect patients and professionals. Almost all health-care institutions (97.7%) provided recommendations on emergency management. No significant differences were found between adult and pediatric centers in terms of infection prevention and control.DiscussionLow variability in patient protection strategies was observed, meaning that national recommendations were effective. However, some critical issues emerged regarding the management of infected health-care professionals and their contacts.

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.

Information Technology and Information Management in Healthcare.

Recent decades made a change in health care by putting health information as a core asset for effective management and improved quality of care. That is a reason why applications of information technology in health and healthcare attract more attention by healthcare organisations with highly skilled health information management professionals having an active role in the effective maintenance of organized and accurate electronic healthcare data. Also, widely adopted standards and principles of healthcare information governance are essential in efforts to reach a compromise of shared data, information and knowledge in the interoperable, electronic healthcare information sharing environment.

A collaborative healthcare framework for shared healthcare plan with ambient intelligence

The fast propagation of the Internet of Things (IoT) devices has driven to the development of collaborative healthcare frameworks to support the next generation healthcare industry for quality medical healthcare. This paper presents a generalized collaborative framework named collaborative shared healthcare plan (CSHCP) for cognitive health and fitness assessment of people using ambient intelligent application and machine learning techniques. CSHCP provides support for daily physical activity recognition, monitoring, assessment and generate a shared healthcare plan based on collaboration among different stakeholders: doctors, patient guardians, as well as close community circles. The proposed framework shows promising outcomes compared to the existing studies. Furthermore, the proposed framework enhances team communication, coordination, long-term plan management of healthcare information to provide a more efficient and reliable shared healthcare plans to people.

Professionalism of Information Management in Health Care: Development and Validation of the Construct and Its Measurement

Against the background of a steadily increasing degree of digitalization in health care, a professional information management (IM) is required to successfully plan, implement, and evaluate information technology (IT). At its core, IM has to ensure a high quality of health data and health information systems to support patient care. The goal of the present study was to define what constitutes professional IM as a construct as well as to propose a reliable and valid measurement instrument. To develop and validate the construct of professionalism of information management (PIM) and its measurement, a stepwise approach followed an established procedure from information systems and behavioral research. The procedure included an analysis of the pertaining literature and expert rounds on the construct and the instrument, two consecutive and comprehensive surveys at the national and international level, exploratory and confirmatory factor analyses as well as reliability and validity testing. Professionalism of information management was developed as a construct consisting of the three dimensions of strategic, tactical, and operational IM as well as of the regularity and cyclical phases of IM procedures as the two elements of professionalism. The PIM instrument operationalized the construct providing items that incorporated IM procedures along the three dimensions and cyclical phases. These procedures had to be evaluated against their degree of regularity in the instrument. The instrument proved to be reliable and valid in two consecutive measurement phases and across three countries. It can be concluded that professionalism of information management is a meaningful construct that can be operationalized in a scientifically rigorous manner. Both science and practice can benefit from these developments in terms of improved self-assessment, benchmarking capabilities, and eventually, obtaining a better understanding of health IT maturity.

Fuzzy-Based Symmetrical Multi-Criteria Decision-Making Procedure for Evaluating the Impact of Harmful Factors of Healthcare Information Security

Growing concern about healthcare information security in the wake of alarmingly rising cyber-attacks is being given symmetrical priority by current researchers and cyber security experts. Intruders are penetrating symmetrical mechanisms of healthcare information security continuously. In the same league, the paper presents an overview on the current situation of healthcare information and presents a layered model of healthcare information management in organizations. The paper also evaluates the various factors that have a key contribution in healthcare information security breaches through a hybrid fuzzy-based symmetrical methodology of AHP-TOPSIS. Furthermore, for assessing the effect of the calculated results, the authors have tested the results on local hospital software of Varanasi. Tested results of the factors are validated through the comparison and sensitivity analysis in this study. Tabulated results of the proposed study propose a symmetrical mechanism as the most conversant technique which can be employed by the experts and researchers for preparing security guidelines and strategies.