An ICT infrastructure to integrate clinical and molecular data in oncology research

<p>Abstract</p> <p>Background</p> <p>The ONCO-i2b2 platform is a bioinformatics tool designed to integrate clinical and research data and support translational research in oncology. It is implemented by the University of Pavia and the IRCCS Fondazione Maugeri hospital (FSM), and grounded on the software developed by the Informatics for Integrating Biology and the Bedside (i2b2) research center. I2b2 has delivered an open source suite based on a data warehouse, which is efficiently interrogated to find sets of interesting patients through a query tool interface.</p> <p>Methods</p> <p>Onco-i2b2 integrates data coming from multiple sources and allows the users to jointly query them. I2b2 data are then stored in a data warehouse, where facts are hierarchically structured as ontologies. Onco-i2b2 gathers data from the FSM pathology unit (PU) database and from the hospital biobank and merges them with the clinical information from the hospital information system.</p> <p>Our main effort was to provide a robust integrated research environment, giving a particular emphasis to the integration process and facing different challenges, consecutively listed: biospecimen samples privacy and anonymization; synchronization of the biobank database with the i2b2 data warehouse through a series of Extract, Transform, Load (ETL) operations; development and integration of a Natural Language Processing (NLP) module, to retrieve coded information, such as SNOMED terms and malignant tumors (TNM) classifications, and clinical tests results from unstructured medical records. Furthermore, we have developed an internal SNOMED ontology rested on the NCBO BioPortal web services.</p> <p>Results</p> <p>Onco-i2b2 manages data of more than 6,500 patients with breast cancer diagnosis collected between 2001 and 2011 (over 390 of them have at least one biological sample in the cancer biobank), more than 47,000 visits and 96,000 observations over 960 medical concepts.</p> <p>Conclusions</p> <p>Onco-i2b2 is a concrete example of how integrated Information and Communication Technology architecture can be implemented to support translational research. The next steps of our project will involve the extension of its capabilities by implementing new plug-in devoted to bioinformatics data analysis as well as a temporal query module.</p

The Assessment of Technology Adoption Interventions and Outcome Achievement Related to the Use of a Clinical Research Data Warehouse

Introduction: While funding for research has declined since 2004, the need for rapid, innovative, and lifesaving clinical and translational research has never been greater due to the rise in chronic health conditions, which have resulted in lower life expectancy and higher rates of mortality and adverse outcomes. Finding effective diagnostic and treatment methods to address the complex challenges in individual and population health will require a team science approach, creating the need for multidisciplinary collaboration among practitioners and researchers. To address this need, the National Institutes of Health (NIH) created the Clinical and Translational Science Awards (CTSA) program. The CTSA program distributes funds to a national network of medical research institutions, known as “hubs,” that work together to improve the translational research process. With this funding, each hub is required to achieve specific goals to support clinical and translational research teams by providing a variety of services, including cutting edge use of informatics technologies. As a result, the majority of CTSA recipients have implemented and maintain data warehouses, which combine disparate data types from a range of clinical and administrative sources, include data from multiple institutions, and support a variety of workflows. These data warehouses provide comprehensive sets of data that extend beyond the contents of a single EHR system and provide more valuable information for translational research. Although significant research has been conducted related to this technology, gaps exist regarding research team adoption of data warehouses. As a result, more information is needed to understand how data warehouses are adopted and what outcomes are achieved when using them. Specifically, this study focuses on three gaps: research team awareness of data warehouses, the outcomes of data warehouse training for research teams, and how to measure objectively outcomes achieved after training. By assessing and measuring data warehouse use, this study aims to provide a greater understanding of data warehouse adoption and the outcomes achieved. With this understanding, the most effective and efficient development, implementation, and maintenance strategies can be used to increase the return on investment for these resource-intensive technologies. In addition, technologies can be better designed to ensure they are meeting the needs of clinical and translational science in the 21st century and beyond. Methods: During the study period, presentations were held to raise awareness of data warehouse technology. In addition, training sessions were provided that focused on the use of data warehouses for research projects. To assess the impact of the presentations and training sessions, pre- and post-assessments gauged knowledge and likelihood to use the technology. As objective measurements, the number of data warehouse access and training requests were obtained, and audit trails were reviewed to assess trainee activities within the data warehouse. Finally, trainees completed a 30-day post-training assessment to provide information about barriers and benefits of the technology. Results: Key study findings suggest that the awareness presentations and training were successful in increasing research team knowledge of data warehouses and likelihood to use this technology, but did not result in a subsequent increase in access or training requests within the study period. In addition, 24% of trainees completed the associated data warehouse activities to achieve their intended outcomes within 30 days of training. The time needed for adopting the technology, the ease of use of data warehouses, the types of support available, and the data available within the data warehouse may all be factors influencing this completion rate. Conclusion: The key finding of this study is that data warehouse awareness presentations and training sessions are insufficient to result in research team adoption of the technology within a three-month study period. Several important implications can be drawn from this finding. First, the timeline for technology adoption requires further investigation, although it is likely longer than 90 days. Future assessments of technology adoption should include an individual’s timeline for pursuing the use of that technology. Second, this study provided a definition for outcome achievement, which was completion o

Indoor localization of a mobile robot using sensor fusion : a thesis presented in partial fulfilment of the requirements for the degree of Master of Engineering in Mechatronics with Honours at Massey University, Wellington, New Zealand

Reliable indoor navigation of mobile robots has been a popular research topic in recent years. GPS systems used for outdoor mobile robot navigation can not be used indoor (warehouse, hospital or other buildings) because it requires an unobstructed view of the sky. Therefore a specially designed indoor localization system for mobile robot is needed. This project aims to develop a reliable position and heading angle estimator for real time indoor localization of mobile robots. Two different techniques have been developed and each consisted of three different sensor modules based on infrared sensing, calibrated odometry and calibrated gyroscope. Integration of these three sensor modules is achieved by applying the real time Kalman filter which provides filtered and reliable information of a mobile robot's current location and orientation relative to its environment. Extensive experimental results are provided to demonstrate its improvement over conventional methods like dead reckoning. In addition, a control strategy is developed to control the mobile robot to move along the planned trajectory. The techniques developed in this project have potentials for the application for mobile robots in medical service, health care, surveillances, search and rescue in indoor environments

GAMBARAN PENYIMPANAN OBAT DI GUDANG OBAT INSTALASI FARMASI RUMAH SAKIT UMUM DAERAH LAPANGAN SAWANG SITARO

ABSTRACTStorage must guarantee the qualitiy and safety of pharmaceutical preperations, medical devices, and medical materials after use in accordance with pharmaceutical preparations, medical devices, and medical materials after used in accordance with pharmaceutical requirements.. The aim of this study was to evaluated the storage of medicines and to determine indicators of strengths, weaknesses, opportunities, threats that affect the storage stage in the warehouse of Pharmacy Installation of Lapangan Sawang of Sitaro District Hospital. This research was used descriptive analytical study conducted using qualitative methods. The results showed that there was 4 strength indicators, 3 weakness indicators, 1 opportunity indicator and 3 threat indicators. In conclusion, the Pharmacy Installation warehouse of Lapangan Sawang Hospital is 68% accordance with the Regulation of the Minister of Health No.72 2016, but it needs to be equipped indoor lighting, thermometers and naming (labels) on the storage rack. The warehouse strength indicators are good pharmaceutical supply management system, utilization of inventory evaluation management information systems, access to receiving goods from distributors, the person in charge of pharmaceutical personnel, the weaknesses are the number of human resources that are lacking to meet shifts, the existence of expired or damaged drugs, and have not met warehouse requirements based on the regulation. The warehouse opportunities are the development of an inventory evaluation management information system, the threat of which is the change in the inventory module, distributor regulations regarding non-returnable goods, and demand for goods or drugs during the night shift Key Word:  Storage, Medicine, Hospital Pharmacy InstallationABSTRAKPenyimpanan harus menjamin kualitas dan keamanan Sediaan Farmasi, Alat Kesehatan, dan Bahan Medis Habis Pakai sesuai dengan persyaratan kefarmasian. Tujuan dilakukan penelitian yaitu untuk mengevaluasi penyimpanan obat dan menetapkan indikator kekuatan, kelemahan, peluang, ancaman yang mempengaruhi tahap penyimpanan  di gudang Instalasi Farmasi Rumah Sakit (IFRS) Umum Daerah Lapangan Sawang Sitaro. Penelitian ini merupakan penelitian deskriptif analitis yang dilakukan dengan metode kualitatif. Hasil penelitian menunjukkan terdapat 4 indikator kekuatan, 3 indikator kelemahan, 1 indikator peluang dan 3 indikator ancaman. Kesimpulannya gudang IFRS Umum Daerah Lapangan Sawang 68% sesuai dengan Peraturan Menteri Kesehatan (PMK) No.72 Tahun 2016, namun perlu untuk dilengkapi penerangan dalam ruangan, termometer dan penamaan (label) pada rak penyimpanan. Indikator kekuatannya ialah sistem penataan perbekalan farmasi yang baik, pemanfaatan sistem informasi manajemen evaluasi inventory, akses penerimaan barang dari distributor, penanggung jawab dari tenaga kefarmasian, kelemahannya yaitu kurangnya jumlah SDM untuk memenuhi shift, adanya obat kadaluarsa/rusak, dan belum memenuhi persyaratan gudang berdasarkan PMK. Peluangnya ialah perkembangan sistem informasi manajemen evaluasi inventory, ancamannya yaitu perubahan modul inventory, peraturan distributor barang yang tidak dapat diretur, dan permintaan barang/obat saat shift malam. Kata Kunci: Penyimpanan, Obat, Instalasi Farmasi Rumah Saki

An Intelligent Data Mining System to Detect Health Care Fraud

The chapter begins with an overview of the types of healthcare fraud. Next, there is a brief discussion of issues with the current fraud detection approaches. The chapter then develops information technology based approaches and illustrates how these technologies can improve current practice. Finally, there is a summary of the major findings and the implications for healthcare practice