Supporting Work Activities in Healthcare by Mobile Electronic Patient Records

Abstract. Supporting work activities in healthcare is highly complex and chal-lenging. This paper outlines the findings from a usability study of a commercial PC based electronic patient record (EPR) system at a large Danish hospital and presents our experiences with the design of a mobile counterpart. First, a num-ber of challenges in relation to the use of traditional desktop-based EPR sys-tems in healthcare were identified. Secondly, a mobile context-aware prototype was designed and implemented, which automatically keeps track of contextual factors such as the physical location of patients and staff, upcoming appoint-ments etc. The usability of the mobile EPR prototype was evaluated in a labora-tory as well as in relation to carrying out real work activities at the hospital. Our results indicate that mobile EPR systems can support work activities in healthcare, but that interaction design of such systems must be carefully thought out and evaluated. Specifically, our findings challenge the view of con-text-awareness being a universally useful paradigm for mobile HCI.

Early Detection of Ovarian Cancer Using Gabor Wavelet Phase Quantization and Binary Coding

Ovarian cancer is the 5th most common cancer in women, but it is the most difficult to detect in its early stages. Early detection and treatment of ovarian cancer has been shown to increase the five year survival rate of a woman from 12% if caught in stage four of the disease up to 92% if caught in stage one of the disease. Using signal processing, pattern classification and a learning algorithm, it is possible to identify patterns in high dimensionality mass spectrometry data that distinguishes between cancer and non-cancer ovarian samples. For our research, proteomic spectra were generated using SELDI-TOF mass spectrum data, which was composed of 162 ovarian cancer and 91 non-ovarian cancer samples. We introduce a Gabor filter on the mass spectrometry data and design a binary coding scheme for phase quantization encoding that is used for the pattern classification. This pattern will expose crucial features in the data that can be used to correctly classify unmasked samples for the presence or absence of ovarian cancer. Our proposed algorithm was able to successfully discriminate ovarian cancer and non-ovarian samples that yielded results with sensitivities, specificities and accuracies in the 90% to 100% range

Clinical foundations and information architecture for the implementation of a federated health record service

Clinical care increasingly requires healthcare professionals to access patient record information that may be distributed across multiple sites, held in a variety of paper and electronic formats, and represented as mixtures of narrative, structured, coded and multi-media entries. A longitudinal person-centred electronic health record (EHR) is a much-anticipated solution to this problem, but its realisation is proving to be a long and complex journey. This Thesis explores the history and evolution of clinical information systems, and establishes a set of clinical and ethico-legal requirements for a generic EHR server. A federation approach (FHR) to harmonising distributed heterogeneous electronic clinical databases is advocated as the basis for meeting these requirements. A set of information models and middleware services, needed to implement a Federated Health Record server, are then described, thereby supporting access by clinical applications to a distributed set of feeder systems holding patient record information. The overall information architecture thus defined provides a generic means of combining such feeder system data to create a virtual electronic health record. Active collaboration in a wide range of clinical contexts, across the whole of Europe, has been central to the evolution of the approach taken. A federated health record server based on this architecture has been implemented by the author and colleagues and deployed in a live clinical environment in the Department of Cardiovascular Medicine at the Whittington Hospital in North London. This implementation experience has fed back into the conceptual development of the approach and has provided "proof-of-concept" verification of its completeness and practical utility. This research has benefited from collaboration with a wide range of healthcare sites, informatics organisations and industry across Europe though several EU Health Telematics projects: GEHR, Synapses, EHCR-SupA, SynEx, Medicate and 6WINIT. The information models published here have been placed in the public domain and have substantially contributed to two generations of CEN health informatics standards, including CEN TC/251 ENV 13606

An Investigation of the Public Health Informatics Research and Practice in the Past Fifteen Years from 2000 to 2014: A Scoping Review in MEDLINE

Objective: To examine the extent and nature of existing Public Health Informatics (PHI) studies in the past 15 years on MEDLINE. Methods: This thesis adopted the scientific scoping review methodology recommended by Arksey and O’Malley in 2005. It proceeded with the five main stages, which were: Stage I - identifying the research question; Stage II - identifying relevant studies; Stage III - study selection; Stage IV - charting the data; and Stage V - collating, summarizing, and reporting the results. Each methodological stage was carried out with the joint collaboration with the academic supervisor and a final result and conclusion were set forth. Results: The results of this study captured a total number of 486 articles in MEDLINE focused in PHI. Out of them, a majority belonged to the USA followed by the UK, Australia and Canada. Only about one fifth of the articles were from the rest of the world. Further, About 60% of the articles represented infectious disease monitoring, outbreak detection, and bio-terrorism surveillance. Furthermore, about 10% belonged to chronic disease monitoring; whereas public health policy system and research represented 40% of the total articles. The most frequently used information technology were electronic registry, website, and GIS. In contrast, mass media and mobile phones were among the least used technologies. Conclusion: Despite multiple research and discussions conducted in the past 15 years (starting from 2000), the PHI system requires further improvements in the application of modern PHT such as wireless devices, wearable devices, remote sensors, remote/ cloud computing etc. on various domains of PH, which were scarcely discussed or used in the available literature

The Gallery (2005)

https://digitalcommons.butler.edu/buyearbooks/1092/thumbnail.jp

An Improved Utility Driven Approach Towards K-Anonymity Using Data Constraint Rules

Indiana University-Purdue University Indianapolis (IUPUI)As medical data continues to transition to electronic formats, opportunities arise for researchers to use this microdata to discover patterns and increase knowledge that can improve patient care. Now more than ever, it is critical to protect the identities of the patients contained in these databases. Even after removing obvious “identifier” attributes, such as social security numbers or first and last names, that clearly identify a specific person, it is possible to join “quasi-identifier” attributes from two or more publicly available databases to identify individuals. K-anonymity is an approach that has been used to ensure that no one individual can be distinguished within a group of at least k individuals. However, the majority of the proposed approaches implementing k-anonymity have focused on improving the efficiency of algorithms implementing k-anonymity; less emphasis has been put towards ensuring the “utility” of anonymized data from a researchers’ perspective. We propose a new data utility measurement, called the research value (RV), which extends existing utility measurements by employing data constraints rules that are designed to improve the effectiveness of queries against the anonymized data. To anonymize a given raw dataset, two algorithms are proposed that use predefined generalizations provided by the data content expert and their corresponding research values to assess an attribute’s data utility as it is generalizing the data to ensure k-anonymity. In addition, an automated algorithm is presented that uses clustering and the RV to anonymize the dataset. All of the proposed algorithms scale efficiently when the number of attributes in a dataset is large

Patient Safety and Quality: An Evidence-Based Handbook for Nurses

Compiles peer-reviewed research and literature reviews on issues regarding patient safety and quality of care, ranging from evidence-based practice, patient-centered care, and nurses' working conditions to critical opportunities and tools for improvement