Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

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Machine Learning and Clinical Text. Supporting Health Information Flow

Fluent health information flow is critical for clinical decision-making. However, a considerable part of this information is free-form text and inabilities to utilize it create risks to patient safety and cost-­effective hospital administration. Methods for automated processing of clinical text are emerging. The aim in this doctoral dissertation is to study machine learning and clinical text in order to support health information flow.First, by analyzing the content of authentic patient records, the aim is to specify clinical needs in order to guide the development of machine learning applications.The contributions are a model of the ideal information flow,a model of the problems and challenges in reality, and a road map for the technology development. Second, by developing applications for practical cases,the aim is to concretize ways to support health information flow. Altogether five machine learning applications for three practical cases are described: The first two applications are binary classification and regression related to the practical case of topic labeling and relevance ranking.The third and fourth application are supervised and unsupervised multi-class classification for the practical case of topic segmentation and labeling.These four applications are tested with Finnish intensive care patient records.The fifth application is multi-label classification for the practical task of diagnosis coding. It is tested with English radiology reports.The performance of all these applications is promising. Third, the aim is to study how the quality of machine learning applications can be reliably evaluated.The associations between performance evaluation measures and methods are addressed,and a new hold-out method is introduced.This method contributes not only to processing time but also to the evaluation diversity and quality. The main conclusion is that developing machine learning applications for text requires interdisciplinary, international collaboration. Practical cases are very different, and hence the development must begin from genuine user needs and domain expertise. The technological expertise must cover linguistics,machine learning, and information systems. Finally, the methods must be evaluated both statistically and through authentic user-feedback.Siirretty Doriast

E-health and e-welfare of Finland : Check Point 2022

The report provides an overview of progressive nationwide activities towards better e-services in Finland. The information system services of social welfare and health care are monitored by systematic gathering, analysis, and use of data, which allows the tracking of the progress of operations and the realisation of goals. In 2020 and 2021, six data collections were carried out to produce data for the monitoring of the Finnish ‘Information to support well-being and service renewal, eHealth and eSocial Strategy’. Some of the results presented in the report are also openly available in database cubes

Usability in healthcare : overcoming the mismatch between information systems and clinical work

Usability of clinical information technology (IT) systems is an ongoing topic of discussion. The systems should support healthcare professionals in their daily work with patients. However, critics indicate the prevalence of negative experiences and use related problems. The overall goal of the thesis is to examine the usability of current clinical IT systems from the viewpoint of physicians and nurses for the purposes of further user-centred system development. The thesis includes three empirical studies: a digital dictation study, evaluation of nursing documentation systems, and a national usability questionnaire study with physicians. The research was carried out utilizing contextual inquiry, interaction sequence illustration analysis, and tailored usability questionnaire methods. The research resulted in the following findings and conclusions. Currently used IT systems do not support the daily work and clinical tasks of clinicians well. This is due to numerous usability problems, and lack of computer support for multi-professional and cross-organizational collaboration between clinicians. Major improvements are needed to achieve the potential benefits clinical information and communication technology systems offer. Based on empirical studies, themes for potential improvements are: development of efficient and mobile documentation solutions, redesign of system user interfaces, solutions to support communication and collaboration, customisable and context-specific clinical IT systems, and conceptual redesign of nursing documentation system. In the field of health informatics, a need exists to broaden the scope of usability work. Usability is closely associated with evaluation and testing activities instead of design activities. Hence, the scope of usability is more restricted than it is in user-centred design and usability research fields. In order to overcome the current mismatch between IT systems and clinical work, it is important to understand that usability is extremely context-sensitive by nature. The study results indicated shortcomings in user-centred healthcare IT systems design and end-users' abilities to contribute to development work. User-centred design methods provide a variety of means to analyse, design, and evaluate information and communication systems for clinical purposes. However, the characteristics of the clinical context (e.g. privacy and data security issues, and the wide range of IT systems in use) need to be taken into account when applying the methods and performing research in real-life clinical surroundings

Perspectives on e-HRM in the multinational setting

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E-health and e-welfare of Finland - Check point 2015

The new e-health and e-welfare strategy in Finland aims to support the renewal of the social welfare and health care services and the active role of citizens in maintaining their own well-being. The means include the development of knowledge management and increasing the provision of online services. The overall structural changes taking place in Finnish health and social care will also influence information and communication technologies (ICT). The report provides information about the change in the services and the service system brought on by ICT over time. The report illustrates the status in 2014 as compared with the strategic outcomes and objectives set on ICT to support performance and renewal of social welfare and health care. The results are condensed from four surveys for a comprehensive view: availability and use of ICT in health care as well as in social care, usability of the systems for physicians, and citizens´ use and anticipations. These are accompanied by a review of Finnish health care system and ICT development. For the international reader, the report provides an overview of progressive nationwide activities towards better e-services in Finland

Usability perception of the health information systems in Brazil: the view of hospital health professionals on the electronic health record

Purpose The purpose of this paper is to validate and measure the overall evaluation of electronic health record (EHR) and identify the factors that influence the health information systems (HIS) assessment in Brazil. Design/methodology/approach From February to May 2020, this study surveyed 262 doctors and nurses who work in hospitals and use the EHR in their workplace. This study validated the National Usability-focused HIS Scale (NuHISS) to measure usability in the Brazilian context. Findings The results showed adequate validity and reliability, validating the NuHISS in the Brazilian context. The survey showed that 38.9% of users rated the system as high quality. Technical quality, ease of use and benefits explained 43.5% of the user’s overall system evaluation. Research limitations/implications This study validated the items that measure usability of health-care systems and identified that not all usability items impact the overall evaluation of the EHR. Practical implications NuHISS can be a valuable tool to measure HIS usability for doctors and nurses and monitor health systems’ long-term usability among health professionals. The results suggest dissatisfaction with the usability of HIS systems, specifically the EHR in hospital units. For this reason, those responsible for health systems must observe usability. This tool enables usability monitoring to highlight information system deficiencies for public managers. Furthermore, the government can create and develop actions to improve the existing tools to support health professionals. Social implications From the scale validation, public managers could monitor and develop actions to foster the system’s usability, especially the system’s technical qualities – the factor that impacted the overall system evaluation. Originality/value To the best of the authors’ knowledge, this study is the first to validate the usability scale of EHR systems in Brazil. The results showed dissatisfaction with HIS and identified the factors that most influence the system evaluation

Considerations for introducing a cloud service in health informatics: user experience monitoring of information systems

This thesis will show concrete examples about how user experience monitoring will improve security of health information systems, patient safety, efficiency, and ease of use. This thesis will prove how the current EMR systems that are stand alone in nature lack the ability of advanced error monitoring capabilities. As part of this research, I will demonstrate with detailed interviews and data collection surveys how automated user monitoring systems improve data record accuracy consistently. Key terminology to Electronic Medical Records (EMR’s) and the usability of cloud computing software solutions will be defined. EMR’s are the primary software used in hospitals for charting patient information and this research focuses on the summarization of key information to the history of healthcare technologies and their functionalities. Usability testing, cloud computing, and how security and trust are affecting the adoption of cloud-based services will also be discussed in more detail. Along with the importance of market research, how to create buyer personas, and what drives their need to buy. The study was conducted in collaboration with Adusso Ltd. in Helsinki, Finland to gain better understanding about what motivates hospital IT departments to buy and the main issues with EMR systems. In collaboration with Adusso we investigated a use case example of their existing customer Apotti leveraging the user error reduction and cost saving benefits they experienced after deploying Adusso’s UX2play system. We sought answers to these topics using semi-structured interviews and analyzing our customer profiles. We found that UI layout, interoperability, and the number of clicks that nurses spend in the EMR are major issues that most EMR systems have. This implies that companies using EMR’s should implement user monitoring to pinpoint the issues they do have so that they can be fixed and the work of physicians and clinicians can be improved

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe