Annotating a corpus of clinical text records for learning to recognize symptoms automatically

We report on a research effort to create a corpus of clinical free text records enriched with annotation for symptoms of a particular disease (ovarian cancer). We describe the original data, the annotation procedure and the resulting corpus. The data (approximately 192K words) was annotated by three clinicians and a procedure was devised to resolve disagreements. We are using the corpus to investigate the amount of symptom-related information in clinical records that is not coded, and to develop techniques for recognizing these symptoms automatically in unseen text

Patient Sociotechnical Assemblages: The Distributed Cognition of Health Information Management

Personal health records (PHR) are shifting the capabilities and responsibilities of both patients and providers. Influenced by health IT, concepts like patient-centered care, meaningful use, and patient empowerment are commonplace in the healthcare system. As the popularity of personal health records increases, medical providers, healthcare organizations, and health information system stakeholders require a thorough understanding of how patients use these patient facing information portals in conjunction with other artifacts, objects, and practices to manage and maintain their health. Exploring health information management as a distributed sociotechnical assemblage is the conceptual approach of this research. A distributed cognition perspective lends insight to drawing boundaries and establishing connections of personal health information management practices in conjunction with PHR use. The Department of Veterans Affairs provides a unique setting to further understand PHR use and personal health information management practice through the observation of U.S. military veterans enrolled in the My HealtheVet PHR. This context and conceptual framework lead to the research questions for the proposed study: RQ1a: What are the personal health information management practices of veterans who use a personal health record? RQ1b: What health information management practices become distributed beyond the veteran patient? RQ2a: What health information management assemblages emerge from the distributed work of Veterans that use a personal health record? RQ2b: What are key functions of the health information management assemblages of veterans? Through the use of semi-structured in depth interviews, observations, and surveys, data were collected on 22 patients along with their primary care providers and caretakers. Results from a two cycle qualitative coding analysis and analytical cognitive mapping technique reveal bundles of practices for creating reminders, organizing information, and creating information for asking questions and working with primary care providers. Distributed practices emerged that detail the managing of medication, information that is socially distributed, and patient-provider communication through secure messaging. Three health information management assemblage components emerged from the analysis: health events and experiential information, information techniques, and technology and material practices. Each of these components is understood by the ways they become stabilized or destabilized. This research contributes to implications for the design of patient-focused personal health records and informs clinical practice of patient-centered care. The research also makes conceptual and empirical contributions to the practice of health information management and a patient-centered care model of healthcare delivery

Supporting the information systems requirements of distributed healthcare teams

The adoption of a patient-centric approach to healthcare delivery in the National Health Service (NHS) in the UK has led to changing requirements for information systems supporting the work of health and care practitioners. In particular, the patient-centric approach emphasises teamwork and cross-boundary coordination and collaboration. Although a great deal of both time and money has been invested in modernising healthcare information systems, they do not yet meet the requirements of patient-centric work. Current proposals for meeting these needs focus on providing cross-boundary information access in the form of an integrated Electronic Patient Record (EPR). This research considers the requirements that are likely to remain unmet after an integrated EPR is in place and how to meet these. Because the patient-centric approach emphasises teamwork, a conceptual model which uses care team meta-data to track and manage team members and professional roles is proposed as a means to meet this broader range of requirements. The model is supported by a proof of concept prototype which leverages team information to provide tailored information access, targeted notifications and alerts, and patient and team management functionality. Although some concerns were raised regarding implementation, the proposal was met with enthusiasm by both clinicians and developers during evaluation. However, the area of need is broad and there is still a great deal of work to be done if this work is to be taken forward.EThOS - Electronic Theses Online ServiceGBUnited Kingdo