The Use of Olap Reporting Technology to Improve Patient Care Services Decision Making Within the University Health Center

The purpose of this paper is to demonstrate that it is feasible for the student health center to leverage existing clinical data in a data warehouse by using OLAP reporting in order to improve patient care and health care services decision making. Historically, University health care centers have relied mainly on operational data sources for critical health care decision making. These sources of data do not contain enough information to allow health officials to recognize trends or predict how future changes in health care services might vastly improve overall heath care. Four proof of concept artifacts are constructed through design science research methodology, and a feasibility study is presented to build the case for the adoption of OLAP reporting technology. The study concludes that it is feasible to implement an OLAP reporting infrastructure at the student health center if physicians, clinical staff, and administration clearly define the need for the new technology, develop proper data extraction, loading, and transformation strategy, and adequately provide project management and data warehouse design towards the implementation of the solution

A standards-based ICT framework to enable a service-oriented approach to clinical decision support

This research provides evidence that standards based Clinical Decision Support (CDS) at the point of care is an essential ingredient of electronic healthcare service delivery. A Service Oriented Architecture (SOA) based solution is explored, that serves as a task management system to coordinate complex distributed and disparate IT systems, processes and resources (human and computer) to provide standards based CDS. This research offers a solution to the challenges in implementing computerised CDS such as integration with heterogeneous legacy systems. Reuse of components and services to reduce costs and save time. The benefits of a sharable CDS service that can be reused by different healthcare practitioners to provide collaborative patient care is demonstrated. This solution provides orchestration among different services by extracting data from sources like patient databases, clinical knowledge bases and evidence-based clinical guidelines (CGs) in order to facilitate multiple CDS requests coming from different healthcare settings. This architecture aims to aid users at different levels of Healthcare Delivery Organizations (HCOs) to maintain a CDS repository, along with monitoring and managing services, thus enabling transparency. The research employs the Design Science research methodology (DSRM) combined with The Open Group Architecture Framework (TOGAF), an open source group initiative for Enterprise Architecture Framework (EAF). DSRM’s iterative capability addresses the rapidly evolving nature of workflows in healthcare. This SOA based solution uses standards-based open source technologies and platforms, the latest healthcare standards by HL7 and OMG, Decision Support Service (DSS) and Retrieve, Update Locate Service (RLUS) standard. Combining business process management (BPM) technologies, business rules with SOA ensures the HCO’s capability to manage its processes. This architectural solution is evaluated by successfully implementing evidence based CGs at the point of care in areas such as; a) Diagnostics (Chronic Obstructive Disease), b) Urgent Referral (Lung Cancer), c) Genome testing and integration with CDS in screening (Lynch’s syndrome). In addition to medical care, the CDS solution can benefit organizational processes for collaborative care delivery by connecting patients, physicians and other associated members. This framework facilitates integration of different types of CDS ideal for the different healthcare processes, enabling sharable CDS capabilities within and across organizations

A Patient-Facing Dashboard to Promote Shingrix™ Vaccination in a Continuing Care Retirement Community: A Quality Improvement Project

BACKGROUND: Shingles is considered one of the most significant vaccine-preventable diseases of older adults based on its morbidity and public health burden, which increase drastically with age. Adult vaccine awareness and promotion programs are undervalued in the U.S.; in particular, educational programs targeting older adults are needed. Older adults have increasing rates of adoption of health information technology (HIT) to seek guidance and support for their medical needs. Leveraging HIT in the form of clinical dashboards is an option for providing reliable, safe and cost-effective vaccine education to older adults at high risk of vaccine-preventable disease. METHODS: The specific aims of this quality improvement project were to increase knowledge and uptake of recombinant zoster vaccine (Shingrix™) in older adults of a continuing retirement community (CCRC) through creation of a patient-facing clinical dashboard. The Four Pillars™ practice transformation program was used to guide implementation of the project including utilization of self-report surveys to determine baseline vaccination rates, perceptions of the dashboard and behavioral intention to receive future vaccination. The Patient Portal Acceptance Model (PPAM) was used as a theoretical framework to evaluate respondents’ perceptions of the dashboard across four domains: ease of use, usefulness, self-efficacy, and privacy/security. RESULTS: Respondents reported high levels of education and computer literacy. The majority reported using the internet for over 20 years and over 10 hours per week and 77.8% had used the internet to search for healthcare information within the past year. Baseline Shingrix™ vaccination levels in the CCRC were higher than national average but not at goal rates, and the majority of respondents eligible for vaccination did not plan to receive it. Respondents rated the dashboard moderately high on perceived ease of use, low on concerns about privacy/security, high on ability to use independently (self-efficacy), and low on perceived usefulness. DISCUSSION: The information provided by CCRC residents during development of this dashboard was valuable for elucidating motivators and barriers to HIT use in older adults, who largely view HIT as an adjunct to in-person interaction with a trusted provider. Improving older adults’ perceptions of HIT will be critical in the era of Covid-19, when many high-risk older adults are seeking alternatives to traditional provider visits. Respondents were willing and able to access and navigate the dashboard; however, shingles knowledge did not improve in this small sample. Improvements in the presentation of the material on the dashboard may improve perceptions of usefulness and comprehension of specialized clinical information. CONCLUSION: CCRC residents were receptive to receiving vaccine information via electronic dashboard and expressed interest in using this format as a source of other healthcare information. There is ample opportunity to expand patient-facing dashboards in the CCRC setting to provide a wide array of healthcare education for this population

Polio eradication strategy 2022\u20132026 : delivering on a promise

Over the last decade, the Global Polio Eradication Initiative (GPEI) made steady progress on the path to eradication. Wild poliovirus types 2 and 3 (WPV2 and WPV3) were declared eradicated in 2015 and 2019, respectively; the World Health Organization (WHO) South-East Asia Region was declared free of poliovirus in 2014; and most recently, the WHO African Region was certified free of wild poliovirus (WPV) in August 2020. However, the final steps towards eradication have proven the most difficult.The GPEI now faces programmatic and epidemiological challenges that demand new approaches to place the partnership and impacted countries on an emergency footing (see Annex B). To achieve a polio-free world, the GPEI has re-envisioned the endgame pathway with an urgent call for collective ownership and accountability across the GPEI partnership and with governments, communities and all other stakeholders.The Polio Eradication Strategy 2022\u20132026 offers a comprehensive set of actions that will position the GPEI to deliver on a promise that brought the world together in a collective commitment to eradicate polio. These actions, many of which are already under way in 2021, will strengthen and empower the GPEI to meet challenges head-on and achieve and sustain a polio-free world.The GPEI will transform its approach in each region and country through five mutually reinforcing objectives that lay the foundation to achieve two elemental goals: Goal One to permanently interrupt all poliovirus transmission in the final WPV-endemic countries of Afghanistan and Pakistan, and Goal Two to stop circulating vaccine-derived poliovirus (cVDPV) transmission and prevent outbreaks in non-endemic countries.Suggested citation. Polio Eradication Strategy 2022\u20132026: Delivering on a promise. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.9789240031937-eng.pdf2021ISBN 978-92-4-003193-7 (electronic version)ISBN 978-92-4-003194-4 (print version)1095

Arizona Health Information Exchange

abstract: Arizona strives to be the national role model for the secure, interoperable health information exchange to facilitate safe, secure, high quality and cost effective health care. The purpose of the Health Information Exchange in Arizona is to improve the quality, safety and efficiency of wellness in the Arizona population by securely connecting patients and health care providers so that relevant and understandable information is available anytime, anywhere

Towards a Learning Health System: a SOA based platform for data re-use in chronic infectious diseases

Abstract Information and Communication Technology (ICT) tools can efficiently support clinical research by providing means to collect automatically huge amount of data useful for the management of clinical trials conduction. Clinical trials are indispensable tools for Evidence-Based Medicine and represent the most prevalent clinical research activity. Clinical trials cover only a restricted part of the population that respond to particular and strictly controlled requirements, offering a partial view of the overall patients\u2019 status. For instance, it is not feasible to consider patients with comorbidities employing only one kind of clinical trial. Instead, a system that have a comprehensive access to all the clinical data of a patient would have a global view of all the variables involved, reflecting real-world patients\u2019 experience. The Learning Health System is a system with a broader vision, in which data from various sources are assembled, analyzed by various means and then interpreted. The Institute of Medicine (IOM) provides this definition: \u201cIn a Learning Health System, progress in science, informatics, and care culture align to generate new knowledge as an ongoing, natural by-product of the care experience, and seamlessly refine and deliver best practices for continuous improvement in health and health care\u201d. The final goal of my project is the realization of a platform inspired by the idea of Learning Health System, which will be able to re-use data of different nature coming from widespread health facilities, providing systematic means to learn from clinicians\u2019 experience to improve both the efficiency and the quality of healthcare delivery. The first approach is the development of a SOA-based architecture to enable data collection from sparse facilities into a single repository, to allow medical institutions to share information without an increase in costs and without the direct involvement of users. Through this architecture, every single institution would potentially be able to participate and contribute to the realization of a Learning Health System, that can be seen as a closed cycle constituted by a sequential process of transforming patient-care data into knowledge and then applying this knowledge to clinical practice. Knowledge, that can be inferred by re-using the collected data to perform multi-site, practice-based clinical trials, could be concretely applied to clinical practice through Clinical Decision Support Systems (CDSS), which are instruments that aim to help physicians in making more informed decisions. With 4 this objective, the platform developed not only supports clinical trials execution, but also enables data sharing with external research databases to participate in wider clinical trials also at a national level without effort. The results of these studies, integrated with existing guidelines, can be seen as the knowledge base of a decision support system. Once designed and developed, the adoption of this system for chronical infective diseases management at a regional level helped in unifying data all over the Ligurian territory and actively monitor the situation of specific diseases (like HIV, HCV and HBV) for which the concept of retention in care assumes great importance. The use of dedicated standards is essential to grant the necessary level of interoperability among the structures involved and to allow future extensions to other fields. A sample scenario was created to support antiretroviral drugs prescription in the Ligurian HIV Network setting. It was thoroughly tested by physicians and its positive impact on clinical care was measured in terms of improvements in patients\u2019 quality of life, prescription appropriateness and therapy adherence. The benefits expected from the employment of the system developed were verified. Student\u2019s T test was used to establish if significant differences were registered between data collected before and after the introduction of the system developed. The results were really acceptable with the minimum p value in the order of 10 125 and the maximum in the order of 10 123. It is reasonable to assess that the improvements registered in the three analysis considered are ascribable to this system introduction and not to other factors, because no significant differences were found in the period before its release. Speed is a focal point in a system that provides decision support and it is highly recognized the importance of velocity optimization. Therefore, timings were monitored to evaluate the responsiveness of the system developed. Extremely acceptable results were obtained, with the waiting times of the order of 10 121 seconds. The importance of the network developed has been widely recognized by the medical staff involved, as it is also assessed by a questionnaire they compiled to evaluate their level of satisfaction

Utilizing TIGER Competencies to Improve Informatics Practice

Nursing Informatics (NI) is quickly becoming an essential part of nursing. From the classroom, to the bedside, and to the boardroom, nurses across the nursing continuum are expected to use NI in their practice with the hopes of delivering better quality care to their patients. However, the training and education of NI provided to all levels of nurses is unable to keep up with the pace of technology. This project seeks to improve the NI competency of the nursing workforce at a pediatric hospital through an educational course using NI competencies identified by the Technology Informatics Guiding Educational Reform (TIGER) Initiative (2009). The value of this project is that it addresses the gap in NI education and competencies at a 265-bed pediatric hospital and creates a NI curriculum that is relevant, timely, and teaches nurses the essential skills to use NI to provide quality care and become a driver of patient quality outcomes

Advisory Committee on Immunization Practices (ACIP) summary report : September 22, 2020, Atlanta, Georgia

Publication date from document properties.min-2020-09.pdf2020https://www.cdc.gov/vaccines/acip/meetings/downloads/min-archive/min-2020-09.pdf878

Bridging Theory to Practice: Utilizing the Culture-Centered Approach (CCA) to Address Gaps in Community Based Participatory Research (CBPR) Processes

The purpose of this study is to provide recommendations to bridging the theoretical with the practical in developing community-based participatory research (CBPR) health communication projects. As illustrated through a review of several case studies from health campaigns using CBPR, often times the theoretical orientations of CBPR become secondary to its praxis, with unspoken motives and agendas become motivating factors in guiding the initiatives. These motives may come in the form of funding organization priorities, funded grant proposal constraints, and the desire to continue relationships that are fostered in the development of CBPR projects. In response, this essay reintroduces the culture-centered approach (CCA) as an additional metatheoretical lens that can be utilized in linking theory to practice. The use of specific reflexive exercises are recommended to draw out unseen power differentials within project partnerships, calling into question the fundamental objectives guiding the decision-making processes within CBPR projects. This essay aspires to compel and strengthen CBPR health communication in practice to become more authentic to the orientation’s original conceptualization