Data wars over data stores: challenges in medical data linkage

A primary concern of the medical e-research community is the availability of suitable data sets for their analysis requirements. The quantity and dubious quality of data present significant barriers to the application of many automated analysis technologies, including data mining, to the medical and health domain. Publicly available data is frequently poorly coded, incomplete, out-of-date or simply not applicable to the analysis or algorithm being applied. Work has been done to overcome these issues through the application of data linking processes but further complications have been encountered resulting in slow progress. The use of locally held medical data is difficult enough due to its structural complexity and non-standardised language, however linking data from disparate electronic sources adds the challenges of privacy, security, semantic compatibility, provenance, and governance, each with its own inherent issues. A focal requirement is a mechanism for the sharing of medical and health data across multiple sites which incorporates careful management of the semantics and limitations of the data sets whilst maintaining functional relevance for the end user. Our paper addresses this requirement by exploring recent conceptual modeling and data evaluation methodologies that facilitate effective data linking whilst ensuring the semantics of the data are maintained and the individual needs of the end user are met

Using standardised patients to assess the quality of medical records: An application and evidence from rural China

Background Medical records play a fundamental role in healthcare delivery, quality assessment and improvement. However, there is little objective evidence on the quality of medical records in low and middle-income countries. Objective To provide an unbiased assessment of the quality of medical records for outpatient visits to rural facilities in China. Methods A sample of 207 township health facilities across three provinces of China were enrolled. Unannounced standardised patients (SPs) presented to providers following standardised scripts. Three weeks later, investigators returned to collect medical records from each facility. Audio recordings of clinical interactions were then used to evaluate completeness and accuracy of available medical records. Results Medical records were located for 210 out of 620 SP visits (33.8%). Of those located, more than 80% contained basic patient information and drug treatment when mentioned in visits, but only 57.6% recorded diagnoses. The most incompletely recorded category of information was patient symptoms (74.3% unrecorded), followed by non-drug treatments (65.2% unrecorded). Most of the recorded information was accurate, but accuracy fell below 80% for some items. The keeping of any medical records was positively correlated with the provider's income (β 0.05, 95% CI 0.01 to 0.09). Providers at hospitals with prescription review were less likely to record completely (β-0.87, 95% CI-1.68 to 0.06). Significant variation by disease type was also found in keeping of any medical record and completeness. Conclusion Despite the importance of medical records for health system functioning, many rural facilities have yet to implement systems for maintaining patient records, and records are often incomplete when they exist. Prescription review tied to performance evaluation should be implemented with caution as it may create disincentives for record keeping. Interventions to improve record keeping and management are needed

A rule based approach to data certification - applying DQXML for system independent data certification

Many researchers and practitioners have been attracted to improve data quality due to its monumental importance as a key success factor. Mathematical and statistical models have been deployed to information systems to introduce constrain and transaction based mechanisms to prevent data quality related problems. Entire management of the process and roles involved in data generation has also been scrutinized. Vast amount of knowledge base progressed in this area are mostly limited from practical perspective. Quality related meta data is absent from most information systems. Neither process mapping nor data modelling provides sufficient provision to measure quality or certification of data in the information systems. Furthermore, on-going monitoring of data for quality conformance through a separate process is expensive and time consuming. Recognising this limitation and aiming to provide a practical-orient comprehensive approach, I propose a process centric quality focused solution incorporating data product quality, conformance monitoring and certification. I base my work on DQXML developed by Ismael Caballero and deploy rigour of design science to construct InfoGuard. InfoGuard consists of DQXML incorporating quality meta data and an independent data quality monitor that provides certification of data through a rule based process centric framework for on-going data quality monitoring

The impact of information quality awareness on users\u27 behaviors toward information quality practices

Healthcare organization rely more on electronic information to optimize most of their processes. Additional information sources and more diverse information increase the relevance and importance of information quality (IQ). The quality of information needs to be improved to support a more efficient and reliable utilization of information systems (IS). This improvement can only be achieved through the implementation of initiatives followed by most users across the organization. The purpose of this study is to develop a model related to how awareness of IS users about IQ issues would affect their actual practices toward IQ initiatives. It is posited that users’ motivation is influenced by their awareness on beneficial and problematic situations generated by IQ. The motivation that users may have regarding IQ impact, will influence their behavior regarding IQ practices. Social influences and facilitating conditions are considered as moderators of the interaction between intention and actual users’ behavior

Dependability and acceptability of handheld computers in school-based data collection

Given the increasing influence of technology and the explosion in data collection demands, the acceptance and assimilation of new paradigms and technologies require today’s educators, researchers, and evaluators to select appropriate tools and apply them effectively. One of these technologies—handheld computers—makes the benefits of computerized data collection more accessible to field-based researchers. Three related studies were conducted to evaluate handheld-based data collection system for use in special education settings and to highlight the acceptability factors to effectively use this emerging technology. The first study reviewed the recent literature on the dependability and willingness of teachers to adopt handheld data collection systems and emphasized five important factors: (1) perceived ease of use; (2) perceived usefulness; (3) intention to use; (4) dependability; and (5) subjective norms. The second study discussed the dependability of handheld computers used by special education teachers for collecting self-report data by addressing four dependability attributes: reliability, maintainability, availability, and safety. Data were collected from five sources: (1) self-reports of time use by 19 special education teachers using Pocket PC computers, (2) observations of time use from eight external data collectors, (3) teacher interviews, (4) technical reports prepared by the researcher, and (5) teacher satisfaction. Results indicated that data collection via handheld computers yielded accurate, complete, and timely data, and was appropriate for these four dependability attributes. The last study investigated teachers’ acceptance of handheld computer use by testing the relationship among five factors that influence intention to use this technology which was based on a modified version of the technology acceptance model using the handheld computer acceptance survey responses from 45 special education teachers. The results showed that intention to use handheld computer was directly affected by the devices’ perceived usefulness and perceived ease of use. The issue of dependability had a direct and indirect statistically significant effect on perceived ease of use and usefulness, and intention to use a handheld computer, respectively. Overall, three studies demonstrated that handheld computers can be effectively used in the direct observation of behavior in a school environment, without requirements of any settings

Electronic patient records system in Hamad Medical Corporation, Qatar: perspectives and potential use

Since the 1990 the use of Electronic Patient Records (EPR) in health services has become increasingly prevalent world wide. EPR has become an important aspect of the continuous improvement of patient care. Transferring all patient records from paper based to electronic is now a priority for many health services. The research reported in this thesis is sponsored by Hamad Medical Corporation (HMC) to provide opportunity to explore the potential role for EPR in the Medical Records Department. The study has been designed to gain better understanding of the users perspectives with regard to the use of patient records. In order to analyse and understand the complex dynamic involved in the management and use of patient records, it was recognised that systems thinking offered an appropriate framework for this research. Soft System Methodology (SSM) was therefore applied to the analysis of the data and used to inform the development of a conceptual model. Using SSM in combination with the structured questionnaire survey and telephone semi-structured interview, triangulation of methods was achieved. Use of these generated rich data revealing for example the general dissatisfaction expressed with the existing manual patient records system, the lack of confidentiality, poor legibility, shortage of space and the frequent misfiling of records. The need to address these problems has informed the strategic plan for the development and implementation of EPR for HMC. The research has successfully addressed the stated aims and research questions and guided the formulation of proposals for improvements

Enabling the Reuse of Electronic Health Record Data through Data Quality Assessment and Transparency

With the increasing adoption of health information technology and the growth in the resulting electronic repositories of clinical data, the secondary use of electronic health record data has become one of the most promising approaches to enabling and speeding clinical research. Unfortunately, electronic health record data are known to suffer from significant data quality problems. Awareness of the problem of electronic health record data quality is growing, but methods for measuring data quality remain ad hoc. Clinical researchers must handle this complicated problem without systematic or validated methods. The lack of appropriate or trustworthy electronic health record data quality assessment methodology limits the validity of research performed with electronic health record data. This dissertation documents the development of a data quality assessment framework and guideline for clinical researchers engaged in the secondary use of electronic health record data for retrospective research. Through a systematic literature review and interviews with key stakeholders, we identified core constructs of data quality, as well as priorities for future approaches to electronic health record data quality assessment. We used a data-driven approach to demonstrate that data quality is task-dependent, indicating that appropriate data quality measures must be selected, applied, and interpreted within the context of a specific study. On the basis of these results, we developed and evaluated a dynamic guideline for data quality measures in order to help researchers choose data quality measures and methods appropriately within the context of reusing electronic health record data for research

Aspects of product tracking systems in the supply network for caught seafood

Dissertation submitted to Molde University College - Specialized University in Logistics for the degree of Philosophiae Doctor (PhD

Electronic patient records system in Hamad Medical Corporation, Qatar : perspectives and potential use

Since the 1990 the use of Electronic Patient Records (EPR) in health services has become increasingly prevalent world wide. EPR has become an important aspect of the continuous improvement of patient care. Transferring all patient records from paper based to electronic is now a priority for many health services. The research reported in this thesis is sponsored by Hamad Medical Corporation (HMC) to provide opportunity to explore the potential role for EPR in the Medical Records Department. The study has been designed to gain better understanding of the users perspectives with regard to the use of patient records. In order to analyse and understand the complex dynamic involved in the management and use of patient records, it was recognised that systems thinking offered an appropriate framework for this research. Soft System Methodology (SSM) was therefore applied to the analysis of the data and used to inform the development of a conceptual model. Using SSM in combination with the structured questionnaire survey and telephone semi-structured interview, triangulation of methods was achieved. Use of these generated rich data revealing for example the general dissatisfaction expressed with the existing manual patient records system, the lack of confidentiality, poor legibility, shortage of space and the frequent misfiling of records. The need to address these problems has informed the strategic plan for the development and implementation of EPR for HMC. The research has successfully addressed the stated aims and research questions and guided the formulation of proposals for improvements.EThOS - Electronic Theses Online ServiceGBUnited Kingdo