Web-based Portal Research Articles

Changes in opioid prescribing and prescription drug monitoring program utilization following electronic health record integration-Massachusetts, 2018.

In this study, we explored key prescription drug monitoring program-related outcomes among clinicians from a broad cohort of Massachusetts healthcare facilities following prescription drug monitoring program (PDMP) and electronic health record (EHR) data integration. Outcomes included seven-day rolling averages of opioids prescribed, morphine milligram equivalents (MMEs) prescribed, and PDMP queries. We employed a longitudinal study design to analyze PDMP data over a 15-month study period which allowed for six and a half months of pre- and post-integration observations surrounding a two-month integration period. We used longitudinal mixed effects models to examine the effect of EHR integration on each of the key outcomes. Following EHR integration, PDMP queries increased both through the web-based portal and in total (0.037, [95% CI = 0.017, 0.057] and 0.056, [95% CI = 0.035, 0.077]). Both measures of clinician opioid prescribing declined throughout the study period; however, no significant effect following EHR integration was observed. These results were consistent when our analysis was applied to a subset consisting only of continuous PDMP users. Our results support EHR integration contributing to PDMP utilization by clinicians but do not support changes in opioid prescribing behavior.

(372) Clinical Understanding Through Real-World Data to Validate Effectiveness of Treatments in Peyronie’s Disease (CURVE-PD): Registry Design

Abstract Introduction Limited information is available on the treatment modalities, treatment choices and outcomes of patients with Peyronie’s disease (PD). Clinical Understanding through Real-world data to Validate Effectiveness of treatments in Peyronie’s Disease (CURVE-PD) is a prospective longitudinal, multi-center, web-based PD registry, built on the healthie™ platform, that collects relevant real-world information from treating sites, and individuals with PD and their partners and clinicians. Objective The overarching primary objective is two-fold. First, the registry aims to collect real-world data on treatments used for PD (including injectables and any surgical techniques) to understand treatment choice and variability in treatment delivery, and to assess treatment effectiveness. Secondly, to understand the impact of treatments on patient-reported outcomes (PROs) and their partners’ satisfaction as well. Furthermore, the registry also recognizes the importance of evaluating the natural progression of Peyronie’s disease (PD) in men who choose not to pursue active treatment and instead opt for observational approaches. Methods Eligible adults (≥18 years of age) with a confirmed clinical diagnosis of PD who received PD treatment starting at or within 2 weeks before enrollment (“treated”) or have never received PD treatment (“untreated”) are invited to participate by registry site personnel or their treating physician. Untreated patients who initiate PD treatment after enrollment may crossover into the treated group. Using a web-based portal, which is part of the registry, participants complete surveys at enrollment, and, for those who are treated, longitudinally at treatment initiation and at 3- 6-, 9- and 12-months post treatment initiation. Participant surveys include validated PROs such as the Peyronie’s disease questionnaire (PDQ) scale, Peyronie’s disease questionnaire for female sexual partners (PDQ-FSP), international index of erectile function (IIEF) for participants and male sexual partners, patient health questionnaire-9 (PHQ-9), and the Beck anxiety index (BAI). Additionally, participants are asked to provide details on sexual function, and reasons for treatment start and satisfaction with treatment. Designated site staff use the clinician web-based portal to enter information on demographics, medical history, and treatment history for up to 12 months before enrollment. Prospective data collected include information on PD treatments and clinical assessments as performed in routine clinical care (e.g., pre-treatment and post-treatment penile characteristics and PD symptoms) at enrollment, baseline, and each clinical visit. Currently, 15 sites in the United States are planned, with a possible future expansion to additional sites. The target for enrollment in the treated group is a minimum of 1,000 patients with PD. Results CURVE-PD enrollment opened in June 2023, with an anticipated 15 U.S. sites being enrolled over the next few months. Initial data for analysis are anticipated to be available in 2024. Conclusions CURVE-PD is a novel registry where participants with PD and their partners can provide information on quality-of-life impacts in a secure and private evidence generation web-based environment, that links both patient and clinician-reported treatments and assessments. This registry will provide the means for investigating real-world data (RWD) to attain real-world evidence (RWE) for more comprehensive knowledge and evaluation of the natural history, treatment patterns and modalities, and the comparative effectiveness of treatments for PD. Disclosure Yes, this is sponsored by industry/sponsor: Endo Pharmaceuticals Inc. Clarification: Industry funding only - investigator initiated and executed study Any of the authors act as a consultant, employee or shareholder of an industry for: Endo Pharmaceuticals Inc.

The Web-Based Portal SpatialTME Integrates Histological Images with Single-Cell and Spatial Transcriptomics to Explore the Tumor Microenvironment.

SpatialTME provides spatial structure, cellular composition, expression, function, and cell-cell interaction information to enable investigations into the tumor microenvironment at the spatial level to advance understanding of cancer development and treatment.

Rapid Access Scheduler: A Web-Based System for Direct Provider Scheduling to Pediatric Neurology.

Access to pediatric neurology care is limited, and outpatient waits can exceed 6 months. The referral process is often complex and burdensome. Our objective was to trial a program for scheduling access to pediatric neurology, to be controlled and accessed directly by outside providers. We developed a web-based automated system, "Rapid Access Scheduler" (RASr), for direct scheduling by outside providers. RASr is built around a calendar view that allows the provider to see and reserve an available slot at the time of care. Once a slot is reserved, the scheduling team contacts the family to finalize scheduling. The RASr system is a novel approach for facilitating pediatric neurology patient access through direct scheduling by outside providers using a web-based portal. Advantages of this include control and responsibility by outside providers, easy visibility of availability, and opportunity to inform patients and families at their point-of-care.

Designing and Developing a Mobile App for Management and Treatment of Gestational Diabetes in Nepal: User-Centered Design Study.

Mobile apps can aid with the management of gestational diabetes mellitus (GDM) by providing patient education, reinforcing regular blood glucose monitoring and diet/lifestyle modification, and facilitating clinical and social support. This study aimed to describe our process of designing and developing a culturally tailored app, Garbhakalin Diabetes athawa Madhumeha-Dhulikhel Hospital (GDM-DH), to support GDM management among Nepalese patients by applying a user-centered design approach. A multidisciplinary team of experts, as well as health care providers and patients in Dhulikhel Hospital (Dhulikhel, Nepal), contributed to the development of the GDM-DH app. After finalizing the app's content and features, we created the app's wireframe, which illustrated the app's proposed interface, navigation sequences, and features and function. Feedback was solicited on the wireframe via key informant interviews with health care providers (n=5) and a focus group and in-depth interviews with patients with GDM (n=12). Incorporating their input, we built a minimum viable product, which was then user-tested with 18 patients with GDM and further refined to obtain the final version of the GDM-DH app. Participants in the focus group and interviews unanimously concurred on the utility and relevance of the proposed mobile app for patients with GDM, offering additional insight into essential modifications and additions to the app's features and content (eg, inclusion of example meal plans and exercise videos).The mean age of patients in the usability testing (n=18) was 28.8 (SD 3.3) years, with a mean gestational age of 27.2 (SD 3.0) weeks. The mean usability score across the 10 tasks was 3.50 (SD 0.55; maximum score=5 for "very easy"); task completion rates ranged from 55.6% (n=10) to 94.4% (n=17). Findings from the usability testing were reviewed to further optimize the GDM-DH app (eg, improving data visualization). Consistent with social cognitive theory, the final version of the GDM-DH app supports GDM self-management by providing health education and allowing patients to record and self-monitor blood glucose, blood pressure, carbohydrate intake, physical activity, and gestational weight gain. The app uses innovative features to minimize the self-monitoring burden, as well as automatic feedback and data visualization. The app also includes a social network "follow" feature to add friends and family and give them permission to view logged data and a progress summary. Health care providers can use the web-based admin portal of the GDM-DH app to enter/review glucose levels and other clinical measures, track patient progress, and guide treatment and counseling accordingly. To the best of our knowledge, this is the first mobile health platform for GDM developed for a low-income country and the first one containing a social support feature. A pilot clinical trial is currently underway to explore the clinical utility of the GDM-DH app.

Evaluation of a web-based information platform on youth depression and mental health in parents of adolescents with a history of depression

Research shows the important role of parents’ mental health literacy in detecting depressive symptoms and supporting their children to seek professional help. Improving mental health literacy in parents has recently gained even greater importance due to the negative impact of the COVID-19 pandemic on children and adolescents’ mental health. The aim of the present experimental pre-post-follow-up study was to examine knowledge change after the reception of contents from an innovative web-based platform (www.ich-bin-alles.de/eltern) containing evidence-based information on youth depression and mental health in parents of adolescents with a history of depression. A second aim was to assess evaluation of the layout and the acceptance of the platform. N = 33 parents of adolescents with a history of depression (either current or remitted depression) were presented different content domains of the website. Participants’ knowledge about depression was assessed at pre- and post-intervention, and at a four week follow-up. Moreover, parents evaluated the acceptance and the layout of the website. The trial was preregistered at clinicaltrials.gov (NCT05335564). The results showed a significant increase in total knowledge from pre to post, which remained stable over the course of four weeks. Explorative analyses showed that sociodemographic variables did not influence the extent of knowledge gain. Acceptance rates were high and evaluations of the website’s layout were positive. The findings show that the web-based information portal is a promising and appealing means to increase parental knowledge on youth depression. Low-threshold psychoeducational approaches like websites are particularly relevant in times of crisis and increased prevalence rates of depressive symptoms and disorders (ehealth). These results are an important basis for future studies as well as approaches that aim to impart knowledge about mental disorders like youth depression via web-based means. Furthermore, they bear implications for policy decisions concerning mental health education and campaigns.

CoVProt: Toward a Mass Spectrometry Data Portal for COVID-19 Proteomics Research and Development.

The coronavirus disease 2019 (COVID-19) pandemic has wreaked havoc globally. Beyond the pandemic, the long-term effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus in multiple organ systems are yet to be deciphered. This calls for continued systems science research. Moreover, the host response to SARS-CoV-2 varies person-to-person and gives rise to different degrees of morbidity and mortality. Mass spectrometry (MS) has been a proven asset in studies of the SARS-CoV-2 from an omics systems science lens. To strengthen the proteomics research dedicated to COVID-19, we introduce here a web-based portal, CoVProt. The portal is work in progress and aims for a comprehensive curation of MS-based proteomics data of COVID-19 clinical samples for deep proteomic investigations, data visualization, and easy data accessibility for life sciences innovations and planetary health research community. Currently, CoVProt contains information on 2725 different proteins and 37,125 different peptides from six data sets covering a total of 202 clinical samples. Moreover, all pertinent data sets extracted from the literature have been reanalyzed using a common analysis pipeline developed by combining multiple tools. Going forward, we anticipate that the CoVProt portal will also provide access to the clinical parameters of the patients. The CoVProt (v1.0) portal addresses an existing significant gap to study COVID-19 host proteomics, which, to the best of our knowledge, is the first effort in this direction. We believe that CoVProt is poised to make contributions as a community resource for proteomic applications and aims to broadly support clinical studies to facilitate the discovery of COVID-19 biomarkers and therapeutics with translational potential.

Investigating the Correlation between Patient Education on Web-Based Portal Functionality and the Reduction in 30-Day Hospital Readmission Rates

Investigating the Correlation between Patient Education on Web-Based Portal Functionality and the Reduction in 30-Day Hospital Readmission Rates

Key Features of Smart Medication Adherence Products: Updated Scoping Review.

Older adults often face challenges in self-managing their medication owing to physical and cognitive limitations, complex medication regimens, and packaging of medications. Emerging smart medication dispensing and adherence products (SMAPs) offer the options of automated dispensing, tracking medication intake in real time, and reminders and notifications. A 2021 review identified 51 SMAPs owing to the rapid influx of digital technology; an update to this review is required. This review aims to identify new products and summarize and compare the key features of SMAPs. Gray and published literature and videos were searched using Google, YouTube, PubMed, Embase, and Scopus. The first 10 pages of Google and the first 100 results of YouTube were screened using 4 and 5 keyword searches, respectively. SMAPs were included if they were able to store and allowed for the dispensation of medications, tracked real-time medication intake data, and could automatically analyze data. Products were excluded if they were stand-alone software applications, not marketed in English, not for in-home use, or only used in clinical trials. In total, 5 researchers independently screened and extracted the data. This review identified 114 SMAPs, including 80 (70.2%) marketed and 34 (29.8%) prototypes, grouped into 15 types. Among the marketed products, 68% (54/80) were available for consumer purchase. Of these products, 26% (14/54) were available worldwide and 78% (42/54) were available in North America. There was variability in the hardware, software, data collection and management features, and cost of the products. Examples of hardware features include battery life, medication storage capacity, availability of types and number of alarms, locking features, and additional technology required for use of the product, whereas software features included reminder and notification capabilities and availability of manufacturer support. Data capture methods included the availability of sensors to record the use of the product and data-syncing capabilities with cloud storage with short-range communications. Data were accessible to users via mobile apps or web-based portals. Some SMAPs provided data security assurance with secure log-ins (use of personal identification numbers or facial recognition), whereas other SMAPs provided data through registered email addresses. Although some SMAPs were available at set prices or free of cost to end users, the cost of other products varied based on availability, shipping fees, and subscription fees. An expanding market for SMAPs with features specific to at-home patient use is emerging. Health care professionals can use these features to select and suggest products that meet their patients' unique requirements.

The effect of retailer CSR and consumer environmental responsibility on green consumption behaviors: mediation of environmental concern and customer trust

PurposeGrowing environmental issues worldwide need the engagement of all stakeholders to compliance with the decisions of global leaders made at COP21 and COP26. In this regard, the present study looks at the influence of retailer social responsibility and consumer environmental responsibility by reinforcing consumer’s green consumption behaviors. Similarly, the proposed study incorporates the mediating role of customer trust and environmental concern to understand whether retailer corporate social responsibility and consumer environmental responsibility strengthen green consumption behavior.Design/methodology/approachMultiple hypotheses have been developed in light of the theoretical analysis of the available literature. The information was gathered through a survey method. A web-based portal was used to administer the survey, and 340 useable responses were processed by SPSS 23.0 and AMOS 23.0 for experiential analysis. First, the validity and reliability were evaluated. The authors then tested potential relationships using structural equation modeling.FindingsSurvey data analyzed using the SEM approach reveal that consumer environmental responsibility and retailer CSR does not drive green consumption behavior directly. However, green concern and consumer trust mediates the relation of consumer environmental responsibility and retailer CSR towards green consumption behavior. Another mediating path was also tested through environmental responsibility and green concern among retailer's CSR and green consumption behavior. The outcomes of this path are also significant.Practical implicationsThe study holds promising implications for green consumption behaviors. The following can be achieved by implementing more sustainable supply chain strategies, such as lowering carbon footprint, purchasing eco-friendly goods and supporting environmental causes through retailers and consumers as well.Originality/valueThis study investigated the joint contribution of retailer CSR and environmental responsibility to green consumption for the first time. The work strengthens the body of knowledge in the field of managerial decision-making and creates new directions for scholarly investigation.

Safety Evaluation in Iterative Development of Wearable Patches for Aripiprazole Tablets With Sensor: Pooled Analysis of Clinical Trials.

Wearable sensors in digital health may pose a risk for skin irritation through the use of wearable patches. Little is known about how patient- and product-related factors impact the risk of skin irritation. Aripiprazole tablets with sensor (AS, Abilify MyCite; Otsuka America Pharmaceutical, Inc) is a digital medicine system indicated for the treatment of patients with schizophrenia, bipolar I disorder, and major depressive disorder. AS includes aripiprazole tablets with an embedded ingestible event marker, a wearable sensor attached to the skin through a wearable patch, a smartphone app, and a web-based portal. To continuously improve the final product, successive iterations of wearable patches were developed, including raisin patch version 4 (RP4), followed by disposable wearable sensor version 5 (DW5), and then reusable wearable sensor version 2 (RW2). This analysis pooled safety data from clinical studies in adult participants using the RP4, DW5, and RW2 wearable patches of AS and evaluated adverse events related to the use of wearable patches. Safety data from 12 studies in adults aged 18-65 years from May 2010 to August 2020 were analyzed. All studies evaluated safety, with studies less than 2 weeks also specifically examining human factors associated with the use of the components of AS. Healthy volunteers or patients with schizophrenia, bipolar I disorder, or major depressive disorder were enrolled; those who were exposed to at least 1 wearable patch were included in the safety analysis. Adverse events related to the use of a wearable patch were evaluated. Abrasions, blisters, dermatitis, discoloration, erythema, irritation, pain, pruritus, rash, and skin reactions were grouped as skin irritation events (SIEs). All statistical analyses were descriptive. The analysis included 763 participants (mean [SD] age 42.6 [12.9] years; White: n=359, 47.1%; and male: n=420, 55%). Participants were healthy volunteers (n=269, 35.3%) or patients with schizophrenia (n=402, 52.7%), bipolar I disorder (n=57, 7.5%), or major depressive disorder (n=35, 4.6%). Overall, 13.6% (104/763) of the participants reported at least 1 SIE, all of which were localized to the wearable patch site. Incidence of ≥1 patch-related SIEs was seen in 18.1% (28/155), 14.2% (55/387), and 9.2% (28/306) of participants who used RP4, DW5, and RW2, respectively. Incidence of SIE-related treatment discontinuation was low, which is reported by 1.9% (3/155), 3.1% (12/387), and 1.3% (4/306) of participants who used RP4, DW5, and RW2, respectively. The incidence rates of SIEs reported as the wearable patch versions evolved from RP4 through RW2 suggest that information derived from reported adverse events may have informed product design and development, which could have improved both tolerability and wearability of successive products. Clinicaltrials.gov NCT02091882, https://clinicaltrials.gov/study/NCT02091882; Clinicaltrials.gov NCT02404532, https://clinicaltrials.gov/study/NCT02404532; Clinicaltrials.gov NCT02722967, https://clinicaltrials.gov/study/NCT02722967; Clinicaltrials.gov NCT02219009, https://clinicaltrials.gov/study/NCT02219009; Clinicaltrials.gov NCT03568500, https://clinicaltrials.gov/study/NCT03568500; Clinicaltrials.gov NCT03892889, https://clinicaltrials.gov/study/NCT03892889.

The Implementation of a Virtual Emergency Department: Multimethods Study Guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) Framework.

While the COVID-19 pandemic dramatically increased virtual care uptake across many health settings, it remains significantly underused in urgent care. This study evaluated the implementation of a pilot virtual emergency department (VED) at an Ontario hospital that connected patients to emergency physicians through a web-based portal. We sought to (1) assess the acceptability of the VED model, (2) evaluate whether the VED was implemented as intended, and (3) explore the impact on quality of care, access to care, and continuity of care. This evaluation used a multimethods approach informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Data included semistructured interviews with patients and physicians as well as postvisit surveys from patients. Interviews were transcribed and analyzed using thematic analysis. Data from the surveys were described using summary statistics. From December 2020 to December 2021, the VED had a mean of 153 (SD 25) visits per month. Among them, 67% (n=677) were female, and 75% (n=758) had a family physician. Patients reported that the VED provided high-quality, timely access to care and praised the convenience, shorter appointments, and benefit of the calm, safe space afforded through virtual appointments. In instances where patients were directed to come into the emergency department (ED), physicians were able to provide a "warm handoff" to improve efficiency. This helped manage patient expectations, and the direct advice of the ED physician reassured them that the visit was warranted. There was broad initial uptake of VED shifts among ED physicians with 60% (n=22) completing shifts in the first 2 months and 42% (n=15) completing 1 or more shifts per month over the course of the pilot. There were no difficulties finding sufficient ED physicians for shifts. Most physicians enjoyed working in the VED, saw value for patients, and were motivated by patient satisfaction. However, some physicians were hesitant as they felt their expertise and skills as ED physicians were underused. The VED was implemented using an iterative staged approach with increased service capabilities over time, including access to ultrasounds, virtual follow-ups after a recent ED visit, and access to blood work, urine tests, and x-rays (at the hospital or a local community laboratory). Physicians recognized the value in supporting patients by advising on the need for an in-person visit, booking a diagnostic test, or referring them to a specialist. The VED had the support of physicians and facilitated care for low-acuity presentations with immediate benefits for patients. It has the potential to benefit the health care system by seeing patients through the web and guiding patients to in-person care only when necessary. Long-term sustainability requires a focus on understanding digital equity and enhanced access to rapid testing or investigations.

Applying Customer Discovery Method to a Chronic Disease Self-Management Mobile App: Qualitative Study.

A significant health challenge is evident in the United States, with 6 in 10 adults having a chronic disease and 4 in 10 adults having 2 or more. Chronic disease self-management aims to prevent or delay disease progression and disability and reduce mortality risk. The evidence to support the use of information technology tools, including mobile apps, web-based portals, and web-based educational interventions, that support disease self-management and improve clinical outcomes is growing. Customer discovery and value proposition design methodology is a form of stakeholder engagement and is based on marketing and lean start-up business methods. As applied in health care, customer discovery and value proposition methodology can be used to understand the clinical problem and articulate the product's hypothesized unique value proposition relative to alternative options that are available to end users. This study aims to describe the experience and findings of academic researchers applying the customer discovery and value proposition methodology to identify stakeholders, needs, adaptability, and sustainability of a chronic disease self-management mobile app (CDapp). The motivation of the work is to make mobile health app interventions accessible and acceptable for all segments of patients' chronic diseases. Data were obtained through key informant interviews and analyzed using rapid qualitative analysis techniques. The value proposition framework was used to build the interview guide. The aim was to identify the needs, challenges (pains), and potential benefits (gains) of the CDapp for our stakeholders. Our results showed that the primary consumers (end users) of a CDapp were the patients. The app adopters (decision makers) can be medical center leaders including population health department managers or insurance providers, while the consumer adoption influencers (influencers or saboteurs) are clinicians and patient caregivers. We developed an ecosystem map to visualize the clinical practice workflow and how an app for chronic disease management might integrate within an academic health care center or system. A value proposition for the identified customer segments was generated. Each stakeholder segment was working within a different framework to improve patient self-management. Patients needed help to adhere to self-care activities and they needed tailored health education. Health care leaders aim to improve the quality of care while reducing costs and workload. Clinicians wanted to improve patient education and care while reducing the time burden. Our results also showed that within academic medical centers, there were variations regarding patients' self-reported abilities to manage their diseases. Customer discovery is a useful form of stakeholder engagement when designing studies that seek to implement, adapt, and sustain an intervention. The customer discovery and value proposition methodology can be used as an alternative or complementary approach to formative research to generate valuable information in a brief period.

Integrated Knowledge Translation in the Food and Nutrition Security for Manitoba Youth study

Abstract Background There are concerns that many children do not have healthy diets, which may be related to dietary choices as well as lack of access to healthy foods. The Food and Nutrition Security for Manitoba Youth (FANS) study examined diet, nutrition-related behaviours and food security of 1587 grade nine students in Manitoba, Canada. Results show that while one in five students were food insecure, almost all need significant dietary improvements. Engaging stakeholders through multiple communication channels is key to disseminating research outcomes to drive action for policy change. Methods Principles of integrated knowledge translation were followed, including a breadth of dissemination activities, to maximize impact of study results. These included diverse partnerships, academic and non-academic research outputs, and use of media. Results Study partners including academic co-investigators, school authorities, government agencies and non-profit organizations advocating for child nutrition contributed to study design, interpretation and dissemination. Results were published in academic journals, as well as translated into a suite of non-academic outputs including a community report, infographics (circulated on social media), and a searchable data dashboard, available through a web-based portal. This approach allows for tracking of research output downloads, which number over 500 to date. Due to active outreach to traditional media, study results received widespread attention adding to the breadth of knowledge translation methods employed. This also led to uptake by provincial health education curriculum developers. Results will also be circulated during an upcoming provincial election as part of engaging candidates around child nutrition and food security issues and policies. Conclusions This broad approach to integrated knowledge translation has resulted in extensive distribution of FANS study results and has potential to influence public health nutrition policy. Key messages • Integrated knowledge translation and a breadth of dissemination strategies in the FANS study has led to extensive distribution of research outputs and media coverage. • The FANS knowledge portal, with diverse academic and non-academic research outputs including a data dashboard, is strategic for public health nutrition promotion and advocacy.

Implementation of a Systematic, Digital Oncology Workflow for Patient Distress Screening in a National, Multi-Site Radiotherapy Outpatient Setting.

Distress screening is recommended as standard of care in oncology to improve the quality of personalized care for patients, however previously reported barriers have led to poor uptake and reporting of clinician follow up and interventions. Our purpose was to improve the quality of personalized care for patients with high patient participation rate (>50%), clinical and nurse workflow compliance rate (>70%) and create structured data for practice improvement. To achieve this purpose, an in-house systematic digital screen and templated well-being plan (WBP) workflow was implemented across 33 outpatient Radiation Oncology sites in a multi-institutional center. An in-house digital version of the NCCN Distress Thermometer and Problem Checklist (DT) was built in the integrated web-based portal for patients to complete at home or in a clinic setting. A digital workflow was co-designed with clinicians with automatic integration of the DT PDF document into the Electronic Medical Record (EMR), assigned for doctor review. Nurses subsequently recorded screening actions in the WBP. An extensive engagement, education and support program was completed nationally with phased implementation after an initial pilot at 3 sites. Staff and patient feedback were documented and presented with the collated data for review. The program was successfully implemented at 33 centers across Australia in the multi-site organization between March and October 2022. A total of 7788 distress screening forms were submitted with an uptake rate of 78% at baseline and 53% at end of treatment (EOT). DT document approval rates by doctors varied (41%-98%), and WBP was completed for 48-100% of patients, with variations of rates and use noted between states and individuals for both. Referrals were recorded in the WBP for 3% of patients, however, as up to 52% of documentation was not in a WBP (for some states), true referral numbers require further manual analysis. Pairwise analysis of screening scores between time points saw 42% of scores reduced, 34% increased and 24% with no change. Analysis of a subset of patients with increased or no change in score showed 57% had some change in categories of distress, 22% had complete change and 10% had no change. With an increasing global focus on improving patient centered care, implementation of a systematic digital workflow for distress screening and supportive care was achieved resulting in patient identified stressors being addressed as standard of care. Key barriers reported, include confidence discussing screening results with patients and manual workflows at EOT. The provision of a rich data set can also highlight opportunities for clinical practice improvement, cohort-based focus, clinical quality indicators, benchmarking and reporting.

Web-grading-a tool to test personal grading of renal and prostate cancer.

Only a few pathologists have the opportunity to verify their personal grading through objective assessment. This study introduces a web-based grading platform to facilitate and validate the grading of renal cell carcinoma and prostate cancer. Two representative images of two clinically annotated cohorts of 100 cases each of prostate and renal cell carcinoma were used. Each participant was asked to grade a tumor series utilizing a three tiered grading system. Finally, a Kaplan-Meier curve was drawn, and the log-rank test was used for statistical testing of the p-value. The grading of 22 participants (68%) achieved prognostic significance. Further analysis highlighted that only two pathologists were able to reliably separate low- and high-grade tumors from intermediate grades. The limitations of this study are the low number of participants in each of the cohorts and the potential selection bias of the tumor images. This web-based grading portal facilitates the assessment of the validity of grading by individual pathologists. The observation that most participants can only successfully identify high- or low-grade tumors but cannot discriminate between more subtle intermediate grades does indicate that there is a need for the development of more formal training programs for tumor grading.

Digital transparency and the usefulness for open government

Open Government efforts are criticized for providing limited value. Instead of looking at a value, we investigate the usefulness of web-based open government portals and apps. Specifically, we investigated the relationship between digital transparency and usefulness. We analyzed perceived digital transparency and usefulness in a survey of 112 respondents using Partial Least Square (PLS) and Structural Equation Modelling (SEM). The results show that perceived functionality, transparency, and efficiency influence usefulness but that functionality of apps and efficiency are more important than transparency. Usefulness can be created without having high levels of transparency, as the public wants answers to their questions. Apps should be designed for efficient use, as users have limited time and resources. Apps having pre-defined functional views can be useful to provide quick insight but might limit transparency by not offering other views and insights. Opening raw data using portals can provide higher levels of transparency, although more time and effort are needed to analyze. Both portals providing access to raw data and apps having pre-defined views are needed for open government and transparency as they serve other stakeholder groups and purposes.

Breast Tumor Classification using Machine Learning

One of the most contagious illnesses and the second-leading cause of cancer-related death in women is breast cancer. Early detection of tumor is critical for providing healthcare providers with useful clinical information which can help them make a more accurate diagnosis. To accurately diagnose breast cancer, a computer-aided detection (CAD) system that employs machine learning is required. The paper proposes web based tumor prediction system which analyzes different machine learning algorithms for breast tumor classification to determine the best performing model. Different evaluation criteria namely accuracy, ROC AUC, etc are mostly employed for evaluating models but they make the selection of the best model strenuous. A multi-criteria decision making (MCDM) approach has been employed for selecting the best performing model. Further, a web-based portal has been developed to provide the user interface for this functionality.

Design and Implementation The digital transformation of the student clearance system for Soran University

This project aimed at creating and implementing a web-based portal that allows students of the university of soran to be able to commence and complete the annual process of course clearance online instead of physically navigating sections offices. The student clearance system is an internet-based study initiative that will help facilitate the queuing system in the clearance process of the university. The student clearance system can provide an efficient handling of information that is very easy for universities to use since it is internet-based and can be viewed from anywhere and at any time, and this system or process is also performed every year at the end of the second Semester by students. Students at Soran University in all scientific departments can register through this web application and do end-of-year cleaning work at the university. In this way, we will avoid using paper and loss, and the creation of student crowds at the doors of departments. and facilitating students to do so via the Internet. The computer-based architecture in this project was introduced using the PHP language, JavaScript, CSS, HTML and the software database as MySQL. The program created would act as a more effective and productive way of clearing students, eliminating all types of delay and tension, as well as helping you to understand the process involved, as well as how to do your online clearance. This research work uses the compilation of data from the university, materials and the program has been designed to accomplish the project objective efficiently.

Traffic Dapper Mobile Application: An Online Solution

Traffic congestion and road violations have become persistent challenges in urban areas, necessitating the development of efficient systems to address these issues. This abstract presents an overview of a mobile application called Traffic Dapper, designed to make traffic management and empower both traffic police and users. The Traffic Dapper mobile application aims to provide a comprehensive solution by enabling users, traffic police, and administrators to effectively collaborate and communicate. The application comprises three main components: the mobile app for users, the mobile app for traffic police, and the web-based administration portal. The Traffic Dapper mobile application strives to improve traffic management and user engagement through seamless communication and digitalization. By leveraging real-time data, the application empowers users to make informed decisions, promotes transparency in law enforcement, and enables administrators to efficiently oversee the system. Keywords: Traffic Dapper, mobile application, traffic management, police stations, complaints, fines.