Patient Registration System Research Articles

October 7th 2023 mass casualty incident in southern Israel: lessons for emergency preparedness and management

Abstract Background Mass Casualty Incidents (MCIs) pose significant challenges for healthcare systems. While policies are typically crafted based on past experiences, the lessons learned from each incident play a crucial role in enhancing emergency preparedness. On October 7th, 2023, Israel came under the largest terror attack in its history. During an ongoing terror attack, more than 1300 Israelis were killed, and more than 200 were abducted to Gaza. During the first day of the attack, 1457 casualties were evacuated to a hospital, approximately half of them to Soroka University Medical Center (SUMC). This MCI surpassed conventional MCI challenges, necessitating a need to face the unexpected under fire. Through a description of this extreme MCI, we delve into the challenges faced, the strategic interventions deployed to address them, and the invaluable lessons learned. Methods Injury characteristics, severity and outcomes of casualties are presented based on the medical records of all casualties arriving to SUMC between October 7th 6:30 a.m. and October 8th 7:00 a.m. Data regarding patient influx, capacity and hospital resource utilization, were collected from the Patient Registration System and other hospital information systems. Results During the incident, a total of 673 injured arrived at SUMC within a mere 24-h period, at a peak rate of 83 injured per hour. The mean casualty age was 29.6, with male predominance. Gunshot wounds and shrapnel injuries were the dominant types of injuries. Out of the casualties arrived, about half were hospitalized or transferred to receive definitive care at other hospitals after initial care at SUMC. Mortality rate was low, at 2.9% of those admitted alive. Conclusions In this article, we describe the injury characteristics and outcomes of casualties seen at SUMC on October 7th 2023, during one of the largest MCIs in history. We present a detailed overview of the challenges encountered, strategies implemented to address them and lessons learned. These insights hold global relevance, offering actionable guidance for the refinement of future emergency protocols and policies on a global scale.

Reasons for encounter in video contacts at a Danish out-of-hours primary care service: a questionnaire study

ObjectiveTo investigate reasons for encounter in telephone triage contacts to an out-of-hours primary care service for which general practitioners (GPs) use video consultations (video contact), overall and stratified for patient...

CURL Extensions – Weaving a Unique Property Reference Number into Address Histories in the Scottish Community Health Index

The Community Health Index (CHI) is the patient registration system for the National Health Service (NHS) in Scotland, covering the entire population. CHI has long been used as a population Indexing Spine to facilitate health-based data linkage for both operational and research purposes in Scotland. Changes in patient’s residential address since 2000 have been captured in a CHI Address History File. Addresses in CHI are recorded in unstructured free-text format, so property-based analyses and linkage is problematic. In August 2020, 90% of CHI addresses for currently registered patients, and people who had died that year, were seeded with a Unique Property Reference Number (UPRN). This product, called CHI-UPRN Residential Linkage (CURL), enabled NHS Scotland to harness important information on the patient population (5.8 million) and their place of residence, facilitating several data products related to COVID-19. The current project is extending CURL to UPRN-seed the 31 million address histories of everyone registered with a family doctor in Scotland since January 2000. The project, due for completion in Summer 2024, will look at alternative address-matching algorithms with the aim of achieving a 95% UPRN-match rate across the longitudinal CURL file. Quality assurance exercises help us to understand the precision and sensitivity of matching across time and geography. Analysis of how the longitudinal file is constructed across the person and property-level indices permits a deeper understanding of the capabilities and limitations of the CURL product when used to deliver innovative analyses or modelling that link people and places over time.

Noctopus: a novel device and method for patient registration and navigation in image-guided cranial surgery.

A patient registration and real-time surgical navigation system and a novel device and method (Noctopus) is presented. With any tracking system technology and a patient/target-specific registration marker configuration, submillimetric target registration error (TRE), high-precise application accuracy for single or multiple anatomical targets in image-guided neurosurgery or ENT surgery is realized. The system utilizes the advantages of marker-based registration technique and allows to perform automatized patient registration using on the device attached and with patient scanned four fiducial markers. The best possible sensor/marker positions around the patient's head are determined for single or multiple region(s) of interest (target/s) in the anatomy. Once brought at the predetermined positions the device can be operated with any tracking system for registration purposes. Targeting accuracy was evaluated quantitatively at various target positions on a phantom skull. The target registration error (TRE) was measured on individual targets using an electromagnetic tracking system. The overall averaged TRE was 0.22 ± 0.08 mm for intraoperative measurements. An automatized patient registration system using optimized patient-/target-specific marker configurations is proposed. High-precision and user-error-free intraoperative surgical navigation with minimum number of registration markers and sensors is realized. The targeting accuracy is significantly improved in minimally invasive neurosurgical and ENT interventions.

Survival of endodontically treated teeth in public dental service in Northern Finland: a practise-based register study.

The aim of this study was to explore the factors associated with the survival of root canal treated teeth in a practise-based study setting in a 5-year period. This retrospective study used data from the electronic patient registration system of the public dental services of the City of Oulu, Finland. The inclusion criteria for this study were patients aged ≥ 20 years who had root canal treatment (RCT) that was initiated in 2014. One RCT per patient was included in the study. A total of 713 patients met the inclusion criteria. The outcome variable for this study was the extraction of the RCT tooth during the 5-year period. Explanatory variables included age, diagnosis, tooth type (incisive, canine, premolar, molar), RCT technique (manual, motorized), time from RCT initiation to final restoration and type of final restoration (composite, glass ionomer, fixed dental prosthesis). To evaluate the association between the outcome variable and explanatory variables, Cox regression analyses were performed. The overall survival rate was 91%. The middle-aged (40-59-years-old) and the oldest (60 and older) patients had a two-fold risk of extraction compared to younger (20-40-years-old) patients. Similarly, a short length of time from RCT initiation to final restoration (0-14 days) resulted in a nearly three times higher risk of extraction compared to a longer period (≥ 90 days). The 5-year survival rate of RCTs seems high. Extractions were more common among patients over 40 years of age and if the RCT was completed shortly after its initiation.

Parathyroid fine needle aspiration with PTH washout: Can it lead to parathyroid cell seeding in primary hyperparathyroidism?

Although parathyroid fine-needle aspiration (P-FNA) with parathyroid hormone (PTH) washout is effective in detecting preoperative parathyroid lesions, it also presents risks such as fibrosis, hematoma, and, in rare cases, tumor seeding. This study aimed to investigate whether P-FNA with PTH washout leads to the seeding of parathyroid cells along the path of the needle. A retrospective analysis was conducted on patients undergoing minimally invasive parathyroidectomy guided by preoperative PTH washout. Permanent pathology reports, imaging data, and postoperative serum parathyroid hormone and calcium levels were assessed to determine the effectiveness and safety of the procedure. Complications following P-FNA with PTH washout were also reviewed using data from the patient registration system of Bulent Ecevit University. The procedure accurately localized parathyroid adenomas in 87 patients who underwent ultrasound-guided parathyroidectomy following preoperative P-FNA and PTH washout. Postoperatively, 75 patients showed normal parathyroid hormone and calcium levels. Two patients required secondary surgery for contralateral adenomas. Critically, there was no evidence of P-FNA with PTH washout-induced parathyromatosis or seeding during the follow-up. Effective adenoma localization is crucial for successful minimally invasive surgery of hyperparathyroidism. Our study indicates that combining preoperative P-FNAB with PTH washout and imaging enhances adenoma detection, especially when intraoperative PTH measurements are not available, thus improving surgical outcomes. Notably, we found no evidence of cell implantation after P-FNA, suggesting the safety and efficacy of this method for preventing parathyroid cell seeding.

Design of Computerized Patient Registration Application System at Tanjung Pati Health Center

One of the shortcomings of manual patient registration systems is the procedures that affect the efficiency of service care to patients. Therefore, researchers are interested in designing a computerized patient registration application using Microsoft Access software. The type of research used is Research and Development (R&D). This research was conducted at Tanjung Pati Community Health Center, with in-depth interviews with two registration officers. The research results show that the data elements needed to design the patient registration application system, sourced from the Patient Registration Book, will be developed by creating an application system using UML modeling. The application system undergoes Black Box Testing with the result that all components run well. The application system is efficient, with an average comparison of manual patient registration time to system patient registration of 420:180 seconds for new patients and 360:33 seconds for existing patients. The application system is efficient according to the results of interviews with informants. Therefore, the design of the computerized patient registration application system using Microsoft Access meets the needs of the community health center and is efficient in terms of patient registration time. It is recommended that the patient registration application be used continuously in the medical records unit at Tanjung Pati Community Health Center.

FAKTOR YANG BERPENGARUH DARI PERANCANGAN SISTEM PENDAFTARAN ONLINE PASIEN UMUM DI RUMAH SAKIT KHUSUS BEDAH HASTA HUSADA KEPANJEN

The development of information and communication technology in the health sector is currently growing rapidly, as evidenced by the existence of an online registration system. The patient registration system at the Hasta Husada Special Surgical Hospital is still done manually, which requires patients to come to the hospital to register and have their data recorded by officers, then the patient waits to be called to be examined based on the queue number, this will take longer and can result in backlogs. patients in four patient registries. The aim of this research was to determine the influencing factors in designing an online general patient registration system basedm on WhatsApp API-gateway using the Wablas Website and WA Queue at the Hasta Husada Special Surgical Hospital. This research uses descriptive analytical research with a qualitative and quantitative approach. The data collection technique used is a questionnaire, then for problem solving using a fishbone diagram, from the problem the author has the idea to solve the problem by creating a WhatsApp-based online registration program with the Wablas Website and WA Queue, using the F test to determine the factors that influence the design of the registration system on line. The subjects in this study were 8 medical records officers in the registration section. The results of research using the Wablas Website and Queue WA applications show that the average scale for respondents is 2.60, where a scale of 2.60 is included in the agree category, so it is stated that respondents showed the highest score of 3.40, the criteria for agreeing in the ease of the patient registration process.It was concluded that the manual registration process for general patients at the Hasta Husada Special Surgical Hospital required the addition of a new registration system that could make things easier for staff and patients. As a consideration for the IT team and medical records officers to design a WhatsApp API-gateway based online registration system using the Wablas Website and WA Queue.

Trends in congenital clubfoot prevalence and co-occurring anomalies during 1994–2021 in Denmark: a nationwide register-based study

BackgroundCongenital talipes equinovarus (clubfoot) is a common musculoskeletal anomaly, with a suspected multifactorial etiopathogenesis. Herein, we used publicly available data to ascertain liveborn infants with clubfoot delivered in Denmark during 1994–2021, and to classify co-occurring congenital anomalies, estimate annual prevalence, and compare clubfoot occurrence with maternal smoking rates, a commonly reported risk factor. Characterizing this nationwide, liveborn cohort provides a population-based resource for etiopathogenic investigations and life course surveillance.MethodsThis case-cohort study used data from the Danish National Patient Register and Danish Civil Registration System, accessed through the publicly available Danish Biobank Register, to identify 1,315,282 liveborn infants delivered during 1994–2021 in Denmark to Danish parents. Among these, 2,358 infants (65.1% male) were ascertained with clubfoot and classified as syndromic (co-occurring chromosomal, genetic, or teratogenic syndromes) and nonsyndromic (isolated or co-occurring multiple congenital anomalies [MCA]). Annual prevalence estimates and corresponding 95% confidence intervals (CIs) for children with nonsyndromic clubfoot were estimated using Poisson regression and compared with population-based, maternal annual smoking rates obtained from publicly available resources.ResultsInfants most often presented with nonsyndromic clubfoot (isolated = 88.6%; MCA = 11.4%); limb and heart anomalies were the most frequently identified MCAs. Prevalence (per 1,000 liveborn infants) was 1.52 (CI 1.45–1.58) for isolated and 0.19 (CI 0.17–0.22) for MCA clubfoot. Prevalence estimates for both isolated and MCA clubfoot remained relatively stable during the study period, despite marked decreases in population-based maternal smoking rates.ConclusionsFrom 1994 to 2021, prevalence of nonsyndromic clubfoot in Denmark was relatively stable. Reduction in population-level maternal smoking rates did not seem to impact prevalence estimates, providing some support for the suspected multifactorial etiopathogenesis of this anomaly. This nationwide, liveborn cohort, ascertained and clinically characterized using publicly available data from the Danish Biobank Register, provides a population-based clinical and biological resource for future etiopathogenic investigations and life course surveillance.

Digital Literacy Improvement and Patient Registration System Training Through of Good Care Application at Primary Healthcare in Indonesia and Timor Leste

Digital Literacy Improvement and Patient Registration System Training Through of Good Care Application at Primary Healthcare in Indonesia and Timor Leste

Can gallbladder wall thickness and systemic inflammatory index values predict the possibility of conversion from laparoscopy to open surgery?

This study aims to develop an objective marker that predicts the risk of conversion from laparoscopy to open surgery using gallbladder wall thickness and inflammatory index values. A total of 2,920 cholecystectomy patients were screened, including those whose operations were converted to open and those who underwent laparoscopy. A total of 700 cholecystectomy patients who met the study criteria were included in the study. The same team of surgeons performed all operations. The conversion probability from laparoscopic to open cholecystectomy was calculated using the ratio obtained by evaluating inflammatory markers and gallbladder wall thickness (K). The preoperative complete blood count and abdominal ultrasound data of the patients were obtained from our university patient registry system. Age, neutrophil count, gallbladder wall thickness, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), KxNLR, and KxPLR values were all significantly higher in the conversion from laparoscopy to open surgery group compared with the laparoscopic cholecystectomy group. According to the ROC analysis performed on the gallbladder wall thickness values according to the probability of conversion to open surgery, the cutoff value was determined as >3 mm. Gallbladder wall thickness >KxPLR >KxNLR was defined as the diagnostic value order according to the area under the curve. The results of this study showed that gallbladder wall thickness effectively determines the probability of conversion from laparoscopy to open cholecystectomy and multiplying the gallbladder wall thickness (mm) by NLR increased the sensitivity.

Autism Spectrum Disorders Registry in Hamadan, Iran: A Study Protocol

: Autism spectrum disorder (ASD) begins in early childhood and has short-term and long-term effects in later life. Deficits in social communication, social interaction, and limited and repetitive behaviors characterize this disorder. We aimed to develop and design a registration system for ASD patients in Hamadan Province to have comprehensive and valuable epidemiological data for researchers about the frequency, distribution, and causes of ASD. This epidemiological information can help target prevention measures and plan care. By designing and developing a patient registry system for ASD, valuable uniform epidemiological information about the web of causes and consequences of ASD is available. The next step is to utilize valid and reliable information for public health, clinical, or policy purposes.

OECD indicator 'AMI 30-day mortality' is neither comparable between countries nor suitable as indicator for quality of acute care.

Hospital mortality after acute myocardial infarction (AMI, ICD-10: I21-I22) is used as OECD indicator of the quality of acute care. The reported AMI hospital mortality in Germany is more than twice as high as in the Netherlands or Scandinavia. Yet, in Europe, Germany ranks high in health spending and availability of cardiac procedures. We provide insights into this contradictory situation. Information was collected on possible factors causing the reported differences in AMI mortality such as prevalence of risk factors or comorbidities, guideline conform treatment, patient registration, and health system structures of European countries. International experts were interviewed. Data on OECD indicators 'AMI 30-day mortality using unlinked data' and 'average length of stay after AMI' were used to describe the association between these variables graphically and by linear regression. Differences in prevalence of risk factors or comorbidities or in guideline conform acute care account only to a smaller extent for the reported differences in AMI hospital mortality. It is influenced mainly by patient registration rules and organization of health care. Non-reporting of day cases as patients and centralization of AMI care-with more frequent inter-hospital patient transfers-artificially lead to lower calculated hospital mortality. Frequency of patient transfers and national reimbursement policies affect the average length of stay in hospital which is strongly associated with AMI hospital mortality (adj R2 = 0.56). AMI mortality reported from registries is distorted by different underlying populations. Most of the variation in AMI hospital mortality is explained by differences in patient registration and organization of care instead of differences in quality of care, which hinders cross-country comparisons of AMI mortality. Europe-wide sentinel regions with comparable registries are necessary to compare (acute) care after myocardial infarction.

Epidemiologic and clinical characteristics of neuromyelitis optica spectrum disorder patients, A seven years follow-up study from Iran.

Neuromyelitis Optica Spectrum Disorder (NMOSD) is a rare neuroinflammatory disease characterized by recurrent relapses. The most common signs are myelitis and optic neuritis. It can also present by cerebral or brain stem syndromes. There are still many challenges in its diagnosis and treatment, and long-term follow-up studies are needed to see the disease course over time. We established an electronic registration system of NMOSD patients starting from October 2015 in Kashani hospital, Isfahan, Iran. Every suspected patient was documented and included in the follow-up system to survey their disease course. Anti-aquaporine 4 (AQP4) antibody checked for all by cell-based assay method. All information such as demographic and clinical data and laboratory and MRI findings were documented. Participants were followed up for any relapses, new paraclinical tests and drug changes. This study is based on the definite NMOSD cases (according to the 2015 criteria) characteristics and clinical course during 7 years of registration. The study included 173 NMOSD cases and 56 ones were seropositive for AQP4 Ab. Their mean age was 40.02±11.11 years (45.78 in the seropositive group). The mean age at disease onset was about 30.16 years. The mean time of follow-up by our registration system is 55.84±18.94 months (54.82 months in seropositive ones). The annual relapse rate is estimated as 0.47±0.36. Long extended transvers myelitis (LETM) was present in the baseline MRI of 77 patients (44.5%), while 32 of them did not show any related clinical symptoms. 124 patients revealed an abnormality in the first brain MRI. 27 individuals suffer hypothyroidism as the most common comorbid disease. The disease seems to be more prevalent in the west and southwest areas of Isfahan province. The mean age of onset is higher than Multiple Sclerosis (MS) patients, but there are notable pediatric cases too. It should also be noticed that cervical LETM can be asymptomatic at first. Brain MRI abnormalities are frequently observed. The disease is more prevalent in the geographical areas where showing high MS prevalence.

CONTENT ANALYSIS AND VALIDATION METHODOLOGY FOR STRUCTURING AND IMPLEMENTING A STANDARD OPERATING PROCEDURE

The study is developed in order to understand the methodological factors that best lead to the validation of a standardization instrument before a specialized technical body, according to the guideline suggested by Hoskins and criteria indicated by Lynn, in view of the opportunity of legitimation and formalization standard operating procedure (SOP) as a recognized and certified municipal tool. For this, the Standard Operating Procedure is given as an instrument that standardizes the follow-up, endorses the strengthening of the system-user bond and allows for improvements with regard to the degree of confidence of the information allocated in the patient registration system of the basic health units. health. This formalization attests to a milestone in the municipality, parameterizing its actions, further professionalizing its personnel, and guaranteeing the technical functionality relevant to each individual in primary care. The creation of the first municipal POP opens up a fertile and prosperous field for observation for the development of new procedures that contribute to more adequate lines of care, effectiveness in the service, guarantee of regularity in the use of resources, as well as in the assertive feedback of municipal data and referring to the direction of investment and intentionality of subsequent municipal health plans.

Prototyping an Online Patient Registration Based on a Smartphone App at the Malang Primary Health Care

Currently, the patient registration system at the Primary Health Care (PHC) in Malang City still uses a manual registration system with various existing problems, like the emergence of queues and patients jostling in the waiting room, so it takes longer for health services. This study aimed to design a prototype application for online patient registration at the Malang City Health Center. The method used is Research and Development Prototyping. The manufacturing stages start from (1) the identification of basic needs, (2) developing a working prototype, (3) using a prototype (trial), and (4) revising and improving the prototype. The instrument used in this study was an interview guide conducted with two Heads of PHC (Dinoyo and Rampal Celaket) and nine Registration Officers at two Health Centers to determine the need for designing a prototype online registration application. Observations were made regarding the existing IT systems (Hardware and Software) in both PHC, the facilities and infrastructure that support IT systems (rooms, internet networks, etc.) and the documents supporting the processes. The results of this prototype design were in the form of a list of functional and non-functional requirements, business process flow diagrams, data flow diagrams, Entity Relationship Diagrams, and Interface Design, including programming language and user interface. Based on the results of the online patient registration prototype design, it enters the initial stage of using a system design that is by user needs but has yet to reach the implementation stage. However, this prototype can be used as a reference in developing an integrated online registration system with existing information systems at the PHC.
 Keywords: Prototype, Online Registration, Smartphone, Primary Health Care, Patient

Transforming Healthcare Analytics with FHIR: A Framework for Standardizing and Analyzing Clinical Data.

In this study, we discussed our contribution to building a data analytic framework that supports clinical statistics and analysis by leveraging a scalable standards-based data model named Fast Healthcare Interoperability Resource (FHIR). We developed an intelligent algorithm that is used to facilitate the clinical data analytics process on FHIR-based data. We designed several workflows for patient clinical data used in two hospital information systems, namely patient registration and laboratory information systems. These workflows exploit various FHIR Application programming interface (APIs) to facilitate patient-centered and cohort-based interactive analyses. We developed an FHIR database implementation that utilizes FHIR APIs and a range of operations to facilitate descriptive data analytics (DDA) and patient cohort selection. A prototype user interface for DDA was developed with support for visualizing healthcare data analysis results in various forms. Healthcare professionals and researchers would use the developed framework to perform analytics on clinical data used in healthcare settings. Our experimental results demonstrate the proposed framework's ability to generate various analytics from clinical data represented in the FHIR resources.

Website Based Patient Clinical Data Information Filling and Registration System

Patient registration is very important in health care services. Various strategies have been implemented in optimizing services, one of which is by developing a web-based outpatient registration system. The purpose of this study is to build a computer-based web-based outpatient registration information system. The type of research used is descriptive by means of a survey, the variables used are flow and outpatient registration procedures, patient data, doctor data, payment method data, polyclinic data. The object of this research is the Outpatient Registration Officer. The instruments used were interview guidelines and observation guidelines, as well as using the Development Life Cycle (SDLC) system development system. Using PHP, HTML, CSS and Java script programming languages, with MySQL database. This information system can make it easier for patients to register themselves without having to go to the hospital first.

Opportunities and challenges for the high-quality development of hernia and abdominal wall surgery in China

Hernia and abdominal wall surgery is a relatively new subspecialty in surgery. Although it started late in China, after 25 years of rapid development, it has made remarkable achievements and has become an important part of surgery, laying a solid foundation for the further development of the discipline. At the same time, one should also be soberly aware of the present deficiencies in this field. The development of the field should be more detailed and in-depth from the following aspects: correct understanding of new concepts of hernia and abdominal wall surgery, establishment of hernia patient registration and quality control system, technological innovation and development of technical equipment, especially the expansion of robot surgical systems, materials science progression to hernia and abdominal wall surgery. Faced with this challenge, China is expected to achieve high-quality development in the field of hernia and abdominal surgery.

Three-year-cohort-study: clinical and cost effectiveness of an inpatient psychiatric rehabilitation.

There has been a resurgence of interest in psychiatric rehabilitation to cater to patients with chronic and complex mental illnesses. This study is aimed at examining patients' characteristics and the prevalence of psychiatric and non-psychiatric comorbidity in a local inpatient rehabilitation service, as well as to investigate the impact of the whole-system approach to rehabilitation on future utilization of mental health services and to analyze the cost-effectiveness and quality of this service. Patients managed over 3 years in a psychiatric rehabilitation inpatient unit were self-controlled; they were retrospectively (pre-rehabilitation) and prospectively (post-rehabilitation) examined for readmission rate, length of stay (LOS), and emergency room (ER) visits. Relevant information was retrieved from Discharge Abstract Database (DAD), Patient Registration System (STAR), and Emergency Department Information System (EDIS). The quality of care in the rehabilitation unit was examined using the Quality Indicator for Rehabilitative Care (QuIRC), and the cost analysis was conducted using data obtained from a single-payer government medical service insurance (MSI) billing system. Of the 185 patients admitted over the study period, 158 were discharged. There was a significant reduction in readmission rate (64% decrease), LOS (6,585 fewer days spent in hospital), and ER presentations (166 fewer visits) (P < 0.0001), respectively. There were substantial subsequent cost savings in the post-rehabilitation year. In the 3-year study, an inpatient psychiatric rehabilitation service in Nova Scotia, Canada, resulted in the successful discharge of most patients with severe and persistent mental illness to more socially inclusive environments. It also reduced their post-rehabilitation mental health service utilization, hence greatly enhancing the effectiveness and efficiency of these services.