International Health Information Research Articles

Reliability Of E-Health Records and The Importance of Patient Self-Reporting in International Health Information Sharing

Reliability Of E-Health Records and The Importance of Patient Self-Reporting in International Health Information Sharing

Physical therapy registries worldwide: A systematic review.

Nowadays, the demand for physical therapy services has grown significantly over the last few decades due to an aging population, a rise in chronic conditions, and increased awareness of the benefits of physical therapy for injury recovery and managing various health issues. Collecting and managing data from physical therapy services is highly significant and beneficial. One of the information management systems that facilitates data collection related to physical therapy services is a physical therapy registry. In this systematic review, we aimed to identify physical therapy registries worldwide and examine the characteristics and data elements of each registry. PubMed, Scopus, Web of Science, and IEEE databases were searched from inception until March 19, 2023 by using keywords and Medical Subject Headings (MeSH) terms regarding "registries" and "physical therapy." The criteria for inclusion in the study were: (1) studies with the English language; (2) original studies, and online access to the physical therapy registry is available; (3) full-text available; (4) studies related to the aims of the study, and (5) studies that have sufficient available information regarding the minimum datasets and other characteristics physical therapy registry. The methodological quality of the included studies was independently assessed by two reviewers using the Effective Public Health Practice Project's (EPHPP) quality assessment tool. Sixteen studies were eligible to be included. The findings of this review indicated that the oldest physical therapy registry was established in 1992, while the newest one was established in 2017. The USA has the highest number of physical therapy registries (n = 7). Ten registries were funded by the government, and the data source for most registries was collected in clinics (n = 11). The geographical coverage of 10 registries was national. All registries collected administrative data (such as sociodemographic data, healthcare provider's data, and others) and clinical data (such as diagnosis, type of physical therapy intervention, pain location, comorbidities, and others) through web-based systems. The data collection method in half of the registries was retrospective (n = 8 out of 16). According to the EPHPP quality assessment tool, 11 studies (73%) were rated as moderate, 3 (20%) as weak, and 1 (7%) as strong. This systematic review found that most developed countries have implemented web-based physical therapy registries to collect administrative and clinical data at the national level. It is recommended that developing countries design and implement similar registries based on these characteristics and extracted data elements. Additionally, these registries should be designed to enable data sharing and interoperability with other international health information systems.

(043) INACCURATE AND INADEQUATE ICD-10 CODING RELATED TO FEMALE SEXUAL HEALTH THREATENS PATIENT CARE, RESEARCH AND BILLING

Abstract Introduction The International Classification of Diseases (ICD) is an international health information system for the collection, processing, classification, and presentation of mortality statistics. The ICD 10th Edition (ICD-10) is a tool for physicians and billing professionals to accurately bill for the care provided. However, physicians who treat female sexual health (FSH) disorders report difficulty in finding appropriate codes for diagnoses and clinical syndromes (Parish et al. 2021). These issues impede the process for appropriate treatment and allotting the correct reimbursement to providers. Additionally, quantitative and qualitative research on FSH is limited due to the lack of accurate ICD codes for FSH disorders in this cohort. Objective This study aims to evaluate the ICD-10 coding system to assess the accuracy and quality of codes related to common FSH disorders. Methods A list of 50 most commonly encountered clinical FSH diagnoses was created based on clinical practice findings and ISSWSH guidelines. The list was compared against existing ICD-10 codes to characterize current FSH disorders that are recognized in ICD-10 and determine which FSH disorders are billable (ICD10data.com categorizes codes as “billable” or “non-billable”) or missing entirely. FSH diagnoses explicitly listed as an independent diagnosis or generally listed were considered ICD-10 coded. Diagnoses were considered to not have an existing code if they were not explicitly listed independently or under a more general term. Results 44% (n=22) of the diagnoses did not have existing ICD-10 codes, and 6% (n=3) of the diagnoses had appropriate ICD-10 codes but were not billable (Figure 1, Table 1). FSH diagnoses such as “clitoral adhesions”, “clitorodynia” and “persistent genital arousal disorder” were not coded in ICD-10. Many diagnoses were grouped under general terms - pelvic floor pain disorders were grouped under “R10.2: Pelvic and peroneal pain” which included both male and female diagnoses. Other codes had significant diagnostic overlap - “vulvodynia” was separately cataloged as “N94.810: vulvar vestibulitis”, “N94.818: Other vulvodynia” and “N94.819: vulvodynia, unspecified”. There were numerous common FSH diagnoses with incomplete, inaccurate, or outdated ICD codes. Conclusions These findings highlight the pressing need for an expanded, comprehensive, and precise set of ICD codes dedicated to FSH disorders. Without appropriate coding for 50% of FSH diagnoses, clinical care, research, and healthcare billing are severely impeded. It is much more difficult for physicians to accurately classify and bill for their procedures, which may create problems with clinical documentation leading to delayed treatment and poor clinical outcomes. For example, existing codes for “vulvodynia,” a common disorder affecting 16% of women, are vague and unclear, which lacks practicality for charting and billing purposes. Additionally, the limitations of ICD coding make it nearly impossible to research specific disorders, as they can not be searched in databases like TriNetX. These limitations may explain the large gaps in the literature regarding FSH disorders. Additionally, electronic medical records often have outdated ICD codes, further creating obstacles for clinicians. The current gap in classification, including ICD-10 coding and medical records, must be addressed to advance the understanding and management of FSH disorders. Disclosure No.

Recommendations for the Quality Management of Patient-Generated Health Data in Remote Patient Monitoring: Mixed Methods Study.

Patient-generated health data (PGHD) collected from innovative wearables are enabling health care to shift to outside clinical settings through remote patient monitoring (RPM) initiatives. However, PGHD are collected continuously under the patient's responsibility in rapidly changing circumstances during the patient's daily life. This poses risks to the quality of PGHD and, in turn, reduces their trustworthiness and fitness for use in clinical practice. Using a sociotechnical health informatics lens, we developed a data quality management (DQM) guideline for PGHD captured from wearable devices used in RPM with the objective of investigating how DQM principles can be applied to ensure that PGHD can reliably inform clinical decision-making in RPM. First, clinicians, health information specialists, and MedTech industry representatives with experience in RPM were interviewed to identify DQM challenges. Second, these stakeholder groups were joined by patient representatives in a workshop to co-design potential solutions to meet the expectations of all the stakeholders. Third, the findings, along with the literature and policy review results, were interpreted to construct a guideline. Finally, we validated the guideline through a Delphi survey of international health informatics and health information management experts. The guideline constructed in this study comprised 19 recommendations across 7 aspects of DQM. It explicitly addressed the needs of patients and clinicians but implied that there must be collaboration among all stakeholders to meet these needs. The increasing proliferation of PGHD from wearables in RPM requires a systematic approach to DQM so that these data can be reliably used in clinical care. The developed guideline is an important next step toward safe RPM.

10.D. Workshop: Injury Severity Classification and burden of disability measurement

Abstract Globally, injuries cause over 4.3 million deaths per year with incalculable costs for the health, legal, and social systems. Burden of disease analyses are being conducted across the world in order to map the health status of injured population, run comparisons and enable prioritization of preventive and interventional measures. Metrics of injury burden are therefore important indicators of population health that are increasingly being incorporated into national and international health information systems. To prevent injuries and their disabling health consequences, and to effectively reduce injury burden, it is essential to provide policy makers and health system planners with detailed measurements and assessments that allow them to focus resources where they are most needed and areas where more targeted policy attention might be required. However, efforts to fully understand the health outcomes of trauma patients remain inconsistent and insufficient, specifically for certain injury populations and health outcome domains. A wide variety of measures are available to track outcomes after injury in various health domains. Reaching consensus is an important step in benchmarking of outcomes across institutions and injury types to improve quality and advance the field of injury care. Modern, validated measures that are feasible and usable in both research and clinical contexts are needed to facilitate the improvement of quality and comparability of research. The workshop aims to discuss trends and variation of injury burden, which is critical to health system planning. The high human and societal costs as well as inequalities of injury mortality and burden will be highlighted based on comparisons with long-term trends. The workshop will discuss the latest developments in injury severity classification and disability measurement. The most efficient measures to calculate the valid burden of injuries will be presented and comparative measurements across EU countries will be promoted. Limitations of injury classifications and factors introducing uncertainty and potential bias in estimation of disability, will be identified. The workshop will contribute to the identification of evidence-informed tools and measurements of injury burden. Key messages • Some injury outcomes are responsible for huge individual and societal burden but are still difficult to measure. • Multiple measures are developed to assess severity and outcomes: e.g. AIS/ ISS/New ISS/ ICD-10. Efficient prevention and quality care requires validated and easy to use measures.

ATA2022 Annual Conference & Expo May 1–3, 2022Boston, Massachusetts

ATA2022 Annual Conference & Expo May 1–3, 2022Boston, Massachusetts

COVID-19 Pandemic: Economy Transformation in Conditions of Restrictions and Uncertainty

COVID-19 pandemic drastically changed life of people all over the world. The economic situation has become unique in new history. When restrictive measures were introduced economy in the majority of countries functioned according to the temporary economic model. The article studies key economic figures characterizing the economic situation during the first wave of the pandemic, as well as changes in customer behavior of people connected with restrictive measures. The author supports the opinion of some researchers that leaders of many states should pay serious attention to the development of economy of disasters, as COVID-19 pandemic is a real disaster. In this connection the most important aspects of state policy should include: provision of the overall country security and safe life in the critical situation, the development of international public health services and information systems based on network on-line platforms, industry 4.0 and artificial intellect. Proposals were put forward aimed at designing the complex concept of economy of disasters, which shall be developed on the basis of advanced achievements in the fields linked with providing safe life of people. According to the author this concept should be ratified by heads of leading states of the world. Conclusions concerning prospects of developing global economy after COVID-19 pandemic were drawn.

An Environmental Scan of Sex and Gender in Electronic Health Records: Analysis of Public Information Sources.

BackgroundHistorically, the terms sex and gender have been used interchangeably as a binary attribute to describe a person as male or female, even though there is growing recognition that sex and gender are distinct concepts. The lack of sex and gender delineation in electronic health records (EHRs) may be perpetuating the inequities experienced by the transgender and gender nonbinary (TGNB) populations.ObjectiveThis study aims to conduct an environmental scan to understand how sex and gender are defined and implemented in existing Canadian EHRs and current international health information standards.MethodsWe examined public information sources on sex and gender definitions in existing Canadian EHRs and international standards communities. Definitions refer to data element names, code systems, and value sets in the descriptions of EHRs and standards. The study was built on an earlier environment scan by Canada Health Infoway, supplemented with sex and gender definitions from international standards communities. For the analysis, we examined the definitions for clarity, consistency, and accuracy. We also received feedback from a virtual community interested in sex-gender EHR issues.ResultsThe information sources consisted of public website descriptions of 52 databases and 55 data standards from 12 Canadian entities and 10 standards communities. There are variations in the definition and implementation of sex and gender in Canadian EHRs and international health information standards. There is a lack of clarity in some sex and gender concepts. There is inconsistency in the data element names, code systems, and value sets used to represent sex and gender concepts across EHRs. The appropriateness and adequacy of some value options are questioned as our societal understanding of sexual health evolves. Outdated value options raise concerns about current EHRs supporting the provision of culturally competent, safe, and affirmative health care. The limited options also perpetuate the inequities faced by the TGNB populations. The expanded sex and gender definitions from leading Canadian organizations and international standards communities have brought challenges in how to migrate these definitions into existing EHRs. We proposed 6 high-level actions, which are to articulate the need for this work, reach consensus on sex and gender concepts, reach consensus on expanded sex and gender definitions in EHRs, develop a coordinated action plan, embrace EHR change from socio-organizational and technical aspects to ensure success, and demonstrate the benefits in tangible terms.ConclusionsThere are variations in sex and gender concepts across Canadian EHRs and the health information standards that support them. Although there are efforts to modernize sex and gender concept definitions, we need decisive and coordinated actions to ensure clarity, consistency, and competency in the definition and implementation of sex and gender concepts in EHRs. This work has implications for addressing the inequities of TGNB populations in Canada.

Visibility of Community Nursing Within an Administrative Health Classification System: Evaluation of Content Coverage.

BackgroundThe World Health Organization is in the process of developing an international administrative classification for health called the International Classification of Health Interventions (ICHI). The purpose of ICHI is to provide a tool for supporting intervention reporting and analysis at a global level for policy development and beyond. Nurses represent the largest resource carrying out clinical interventions in any health system. With the shift in nursing care from hospital to community settings in many countries, it is important to ensure that community nursing interventions are present in any international health information system. Thus, an investigation into the extent to which community nursing interventions were covered in ICHI was needed.ObjectiveThe objectives of this study were to examine the extent to which International Classification for Nursing Practice (ICNP) community nursing interventions were represented in the ICHI administrative classification system, to identify themes related to gaps in coverage, and to support continued advancements in understanding the complexities of knowledge representation in standardized clinical terminologies and classifications.MethodsThis descriptive study used a content mapping approach in 2 phases in 2018. A total of 187 nursing intervention codes were extracted from the ICNP Community Nursing Catalogue and mapped to ICHI. In phase 1, 2 coders completed independent mapping activities. In phase 2, the 2 coders compared each list and discussed concept matches until consensus on ICNP-ICHI match and on mapping relationship was reached.ResultsThe initial percentage agreement between the 2 coders was 47% (n=88), but reached 100% with consensus processes. After consensus was reached, 151 (81%) of the community nursing interventions resulted in an ICHI match. A total of 36 (19%) of community nursing interventions had no match to ICHI content. A total of 100 (53%) community nursing interventions resulted in a broader ICHI code, 9 (5%) resulted in a narrower ICHI code, and 42 (23%) were considered equivalent. ICNP concepts that were not represented in ICHI were thematically grouped into the categories family and caregivers, death and dying, and case management.ConclusionsOverall, the content mapping yielded similar results to other content mapping studies in nursing. However, it also found areas of missing concept coverage, difficulties with interterminology mapping, and further need to develop mapping methods.

Evaluating EHR and Health Care in Jordan According to the International Health Metrics Network (HMN) Framework and Standards: A Case Study of Hakeem

Hakeem is one of the e-health systems that were implemented in Jordan to support the health care and services of medical sectors by connecting public health hospitals all around Jordan. This paper was carried out as a unique and first study to investigate the effectiveness of Hakeem health system according to the international health information systems standards. The health metrics network (HMN) framework and standards for country health information systems are used to measure the Hakeem system from different perspectives to ensure that it meets its objectives to maintain the required level of medical services in Jordan compared to international systems. The study was conducted on 522 respondents of Hakeem system users from four hospitals and ten health centers in Jordan. Data were collected by a valid and reliable questionnaire and interviews and analyzed by SPSS software. The study results indicated that the conformity extent of Hakeem system's components with HMN framework and standards are in different agreements percentages. Some components are with acceptable percentages such as the integration polices and data processing while other components are with moderate, low, and very lower percentages that needed improvements. In light of the results, the study introduces some recommendations to improve Hakeem systems such as improving the technical support of the entire system and the services used in the pharmacy unit.

Advancing GHSA: Lessons learned about strengthening HIS and disease surveillance

ObjectiveThe objective is to discuss two decades of international experiencein health information and disease surveillance systems strengtheningand synthesize lessons learned as applicable to implementation of theGlobal Health Security Agenda (GHSA).IntroductionRTI International has worked on enhancing health informationand disease surveillance systems in many countries, includingThe Democratic Republic of the Congo (DRC), Guinea, Indonesia,Kenya, Nepal, Philippines, Tanzania, Zambia, and Zimbabwe.Strengthening these systems is critical for all three of the Prevent,Detect and Respond domains within the Global Health SecurityAgenda.We have deep experience in this area, ranging from implementingDistrict Health Information Software (DHIS), electronic medicalrecords, health facility registries, eHealth national strategies,electronic Integrated Disease Surveillance and Response system(eIDSR), mobile real-time malaria surveillance and response, nationalweekly disease surveillance, patient referral system, and communitybased surveillance. These experiences and lessons learned can informwork being done to advance the GHSA.We will discuss several examples, including activities in Zimbabweand Tanzania. RTI has been working in Zimbabwe for over six yearsto strengthen the national health information system. This workhas included the configuration and roll-out of DHIS 2, the nationalelectronic health information system. In doing so, RTI examinedand revitalized the weekly disease surveillance system, improvingdisease reporting timeliness and completeness from 40% to 90%.Additionally, RTI has integrated mobile technology to help morerapidly communicate laboratory test results, a laboratory informationmanagement systems to manage and guide test sample processing,and various other patient level systems in support of health servicedelivery at the local level. This work has involved capacity buildingwithin the ministry of health to allow for sustainable support of healthinformation systems practices and technology and improvements todata dissemination and use practices.Similarly, RTI has worked for more than five years to helpstrengthening the National HIS in Tanzania. These activities haveincluded stakeholder coordination, developing national eHealthstrategy and enterprise architecture, harmonizing indicators,redesigning routine reporting instruments, national DHIS 2 roll-out,information technology infrastructure management and user helpdesk support, reducing the number of parallel information systems,data dissemination and use, development of district health profiles,development of the national health facility registry, and supportingroll-out of the electronic integrated disease surveillance system.MethodsWe will profile selected projects and synthesize critical lessonslearned that pertain to implementation of the GHSA in resourceconstrained countries.ResultsWe will summarize our experience and lessons learned withhealth information and disease surveillance systems strengthening.Topics such as those that relate to advancing the GHSA RealTime Surveillance and Reporting Action Package areas will bediscussed, including: indicator and event based surveillance systems;interoperable, interconnected, electronic real-time reporting system;analysis of surveillance data; syndromic surveillance systems;systems for efficient reporting to WHO, FAO and OIE; and reportingnetwork and protocols in country.ConclusionsOur experience working over the past 14 years in 9 countrieson different HIS and disease surveillance system strengtheningprojects has led to a deep understanding of the challenges aroundimplementation of these systems in limited resource settings. Theseexperiences and lessons learned can inform initiatives and programsto advance the GHSA.

Irreparable Global Spread of Pathogens and International Trade – Infection Monitoring

Abstract There is no systematic monitoring of global spreading of pathogens through international trade carried out by any organisation regulating world-wide trade in animals and their products. A critical evaluation of the impact of international trade provisions on global pathogen spread is missing as well. Data related to this kind of analysis are no more internationally collected. However, information on animal infection occurrence is of paramount importance for decision-making on animal health import conditions based on pathogen introduction risk assessment considering first of all the epizootiological situation in exporting countries. Actual international animal health information system covers just a small part of known animal infections and provides much less information on their occurrence and epizootiological characteristics than before (except for a few selected emergency infections). It provides the importing countries zero or insufficient data for objective risk assessment to avoid pathogen introduction through international trade. Illegal export/import is not recorded in any information system. The globalisation era trade requires much more efficient information system, including monitoring of global spread of pathogenic microflora through trade, as the basis for more effective international preventive and control anti-epizootic measures. There is an urgent need to re-establish animal health information system within the United Nations Organization as its inseparable component for follow-up execution of animal health technical assistance and global anti-epizootic programmes.

A History of the International Conference of Animal Health Information Specialists (ICAHIS) and its Partnership in One Health

This article chronicles the International Conference of Animal Health Information Specialists’ (ICAHIS) beginning in 1992 to the present and describes other groups and conferences formed from the international animal health information conference idea. Throughout its history, ICAHIS has been a forum for colleagues worldwide to discuss, share, and promote animal health information access. This article is a brief history of ICAHIS's origins and the movement it fostered. The 7th ICAHIS, the first in the United States, will occur in Boston, May 3–8, 2013. Previous conferences were held on three continents: Europe, Africa, and Australia.

Introduction to the International Medical Informatics Association

Introduction to the International Medical Informatics Association

Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults.

Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders around the world. Although ergonomic design and training are likely to reduce the risk of workers developing work-related upper limb and neck MSDs, the evidence is unclear. To assess the effects of workplace ergonomic design or training interventions, or both, for the prevention of work-related upper limb and neck MSDs in adults. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, AMED, Web of Science (Science Citation Index), SPORTDiscus, Cochrane Occupational Safety and Health Review Group Database and Cochrane Bone, Joint and Muscle Trauma Group Specialised Register to July 2010, and Physiotherapy Evidence Database, US Centers for Disease Control and Prevention, the National Institute for Occupational Safety and Health database, and International Occupational Safety and Health Information Centre database to November 2010. We included randomised controlled trials (RCTs) of ergonomic workplace interventions for preventing work-related upper limb and neck MSDs. We included only studies with a baseline prevalence of MSDs of the upper limb or neck, or both, of less than 25%. Two review authors independently extracted data and assessed risk of bias. We included studies with relevant data that we judged to be sufficiently homogeneous regarding the intervention and outcome in the meta-analysis. We assessed the overall quality of the evidence for each comparison using the GRADE approach. We included 13 RCTs (2397 workers). Eleven studies were conducted in an office environment and two in a healthcare setting. We judged one study to have a low risk of bias. The 13 studies evaluated effectiveness of ergonomic equipment, supplementary breaks or reduced work hours, ergonomic training, a combination of ergonomic training and equipment, and patient lifting interventions for preventing work-related MSDs of the upper limb and neck in adults.Overall, there was moderate-quality evidence that arm support with alternative mouse reduced the incidence of neck/shoulder disorders (risk ratio (RR) 0.52; 95% confidence interval (CI) 0.27 to 0.99) but not the incidence of right upper limb MSDs (RR 0.73; 95% CI 0.32 to 1.66); and low-quality evidence that this intervention reduced neck/shoulder discomfort (standardised mean difference (SMD) -0.41; 95% CI -0.69 to -0.12) and right upper limb discomfort (SMD -0.34; 95% CI -0.63 to -0.06).There was also moderate-quality evidence that the incidence of neck/shoulder and right upper limb disorders were not reduced when comparing alternative mouse and conventional mouse (neck/shoulder RR 0.62; 95% CI 0.19 to 2.00; right upper limb RR 0.91; 95% CI 0.48 to 1.72), arm support and no arm support with conventional mouse (neck/shoulder RR 0.67; 95% CI 0.36 to 1.24; right upper limb RR 1.09; 95% CI 0.51 to 2.29), and alternative mouse with arm support and conventional mouse with arm support (neck/shoulder RR 0.58; 95% CI 0.30 to 1.12; right upper limb RR 0.92; 95% CI 0.36 to 2.36).There was low-quality evidence that using an alternative mouse with arm support compared to conventional mouse with arm support reduced neck/shoulder discomfort (SMD -0.39; 95% CI -0.67 to -0.10). There was low- to very low-quality evidence that other interventions were not effective in reducing work-related upper limb and neck MSDs in adults. We found moderate-quality evidence to suggest that the use of arm support with alternative mouse may reduce the incidence of neck/shoulder MSDs, but not right upper limb MSDs. Moreover, we found moderate-quality evidence to suggest that the incidence of neck/shoulder and right upper limb MSDs is not reduced when comparing alternative and conventional mouse with and without arm support. However, given there were multiple comparisons made involving a number of interventions and outcomes, high-quality evidence is needed to determine the effectiveness of these interventions clearly. While we found very-low- to low-quality evidence to suggest that other ergonomic interventions do not prevent work-related MSDs of the upper limb and neck, this was limited by the paucity and heterogeneity of available studies. This review highlights the need for high-quality RCTs examining the prevention of MSDs of the upper limb and neck.

Easing the development of healthcare architectures following RM-ODP principles and healthcare standards

RM-ODP has been widely accepted and used in the field of system and software model engineering and of enterprise computing within different environments. One of these specific domains is healthcare, in which the international standard Health Information Services Architecture (HISA) is applied under the directives of RM-ODP. HISA presents a flexible architecture identifying common use cases, actors, information, and services and easing its extension with specific services, systems and information. The HISA standard follows system specification through the RM-ODP viewpoints but it does not consider other features of the reference model, such as the Enterprise language or the UML4ODP specification.In this paper, we introduce the rationale and specification of the three technology-independent viewpoints of an HISA-based architecture conforming to RM-ODP and UML4ODP. Moreover, we evaluate how easy it is to extend this architecture to introduce specific services and elements. As proof of concept we explore security and privacy issues (i.e., requirements, actors, information objects, etc.) and enrich the architecture with suitable objects and services, mainly from access control standardization efforts. In addition, a detailed discussion about the divergences between RM-ODP and HISA is presented.The main contribution of our work is to develop (guided by RM-ODP, HISA, and other standards) a methodology and tools allowing healthcare service developers and designers to build solutions conforming to standards and leveraging the benefits of distribution and interoperability. These tools consist of the specification of three technology-independent viewpoints according to the guidelines of HISA, RM-ODP and UML4ODP for the healthcare domain, and they will be freely available. In parallel, these viewpoints are extended with access control issues, and the adequacy of the HISA extension mechanism is evaluated.

Health-related rehabilitation services: assessing the global supply of and need for human resources

BackgroundHuman resources for rehabilitation are often a neglected component of health services strengthening and health workforce development. This may be partly related to weaknesses in the available research and evidence to inform advocacy and programmatic strategies. The objective of this study was to quantitatively describe the global situation in terms of supply of and need for human resources for health-related rehabilitation services, as a basis for strategy development of the workforce in physical and rehabilitation medicine.MethodsData for assessing supply of and need for rehabilitative personnel were extracted and analyzed from statistical databases maintained by the World Health Organization and other national and international health information sources. Standardized classifications were used to enhance cross-national comparability of findings.ResultsLarge differences were found across countries and regions between assessed need for services requiring health workers associated to physical and rehabilitation medicine against estimated supply of health personnel skilled in rehabilitation services. Despite greater need, low- and middle-income countries tended to report less availability of skilled health personnel, although the strength of the supply-need relationship varied across geographical and economic country groupings.ConclusionThe evidence base on human resources for health-related rehabilitation services remains fragmented, the result of limited availability and use of quality, comparable data and information within and across countries. This assessment offered the first global baseline, intended to catalyze further research that can be translated into evidence to support human resources for rehabilitation policy and practice.

Jocelyn Anne Rankin, PhD, FMLA, 1946–2010

Jocelyn Anne Rankin, PhD, FMLA, 1946–2010

Travel health information at commercial travel websites.

Internet travel purchases accounted for 10% of the travel industry revenue generated in 2001. To ensure that travelers remain healthy during excursions to developing countries, travel health information needs to be available at commercial travel websites. We evaluated the current availability of travel health information at these websites. The existence, adequacy and ease of access of the travel health information provided on commercial travel websites was assessed through a review of the top 25 airline and 20 discount travel websites. Each site was examined to determine whether it provided general information, such as jet lag, or international travel health information, such as malaria prophylaxis. We also assessed hyperlinks to external travel health information websites, such as the CDC, when provided. Travel health information was not available at 20 (44%) commercial travel websites, including 36% of airline and 55% of the discount travel websites. Twenty-eight percent of airline websites contained general information only, 8% links only, and 28% general and international information. Travel health information available at discount travel websites included 10% general only, 30% link only, and 5% general and international information. On average, it took three clicks to access travel health information. Keywords clicked to access travel health information frequently did not obviously refer to health. Each of the six travel health website links provided accurate vaccine and travel health information. However, several links lacked disease-specific maps and details of disease risk (i.e. seasonal and regional variations of malaria risk). Travel health information on commercial travel websites may be the only data available to travelers purchasing online. The information currently provided is generally inadequate. Ideally, commercial travel websites would provide uniform information that is accurate and easily accessible. Internationally recognized organizations should consider establishing guidelines for the information provided on commercial travel websites.

OSHE Information Conference. 4th International Occupational Safety, Health and Environment Information Conference – eOSHE World: seeing the future 2000

OSHE Information Conference. 4th International Occupational Safety, Health and Environment Information Conference – eOSHE World: seeing the future 2000