Consolidated List of Requirements

This document is a consolidated catalogue of requirements for the Electronic Health Care Record (EHCR) and Electronic Health Care Record Architecture (EHCRA), gleaned largely from work done in the EU Framework III and IV programmes and CEN, but also including input from other sources including world-wide standardisation initiatives. The document brings together the relevant work done into a classified inventory of requirements to inform the on-going standardisation process as well as act as a guide to future implementation of EHCRA-based systems. It is meant as a contribution both to understanding of the standard and to the work that is being considered to improve the standard. Major features include the classification into issues affecting the Health Care Record, the EHCR, EHCR processing, EHCR interchange and the sharing of health care information and EHCR systems. The principal information sources are described briefly. It is offered as documentation that is complementary to the four documents of the ENV 13606 Parts I-IV produced by CEN Pts 26,27,28,29. The requirements identified and classified in this deliverable are referenced in other deliverables

Personalized patient education and the internet : Linking health information to the Electronic Patient Record : STEPPS in burn care

Väitöskirja, sis. artikkelitSTEPPS = STructured Evaluated Personalized Patient Support = Rakenteinen, arvioitu ja yksilöllistetty potilastuk

An ontology model for clinical documentation templates

Thesis (S.M.)--Harvard-MIT Division of Health Sciences and Technology, 2005.Includes bibliographical references (leaves 46-47).There are various kinds of clinical documents used in a hospital or clinic setting. With the emergence of Electronic Medical Records, efforts are being made to computerize these documents in a structured fashion in order to enable decision support. With structured data entry, because each fact about the patient is stored discretely and can be retrieved separately, information can be organized and presented in different ways, depending on the needs of the user. A typical structured clinical document contains a range of findings recorded by a physician, nurse or other care. These findings can be thought of as discrete pieces of information, called observations. These observations can be grouped together to form observation sets that can be placed under relevant headers within the document. When building information systems that support structured clinical documentation, these observations and sets are created and stored in catalogs. My thesis addresses the issue of building an ontology model for clinical documentation that supports the creation and management of an observations catalog, observation sets catalog and a clinical document catalog. The ontology can be used as an organizational tool for efficient maintenance of these catalogs. By tagging observations and observation sets with relevant attributes, it is possible to generate intelligent displays of data that are more flexible and dynamic.by Joyce George.S.M

In/visible conflicts: NGOs and the visual politics of humanitarian photography

This article examines the diverse factors shaping NGO involvement with humanitarian photography, paying particular attention to co-operative relationships with photojournalists intended to facilitate the generation of visual coverage of crises otherwise marginalised, or ignored altogether, in mainstream news media. The analysis is primarily based on a case study drawing upon 26 semi-structured interviews with NGO personnel (International Red Cross/Red Crescent Movement, Oxfam and Save the Children) and photojournalists conducted over 2014 to 2016, securing original insights into the epistemic terms upon which NGOs have sought to produce, frame and distribute imagery from recurrently disregarded crisis zones. In this way, the article pinpoints how the uses of digital imagery being negotiated by NGOs elucidate the changing, stratified geo-politics of visibility demarcating the visual boundaries of newsworthiness

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

Supporting Uniform Representation of Data: Structuring Medical Narratives for Care and Research

Electronic patient data are associated with many potential benefits, e.g. data sharing, quality assessment, research, and management of patient care. The degree to which patient data are currently available electronically varies. To harvest the potential benefits of electronic data, the data must also be available in a structured format to enable processing by computer applications. Narrative data are typically recorded as free text. As a result, researchers still have to perform the labor-intensive task of reading and interpreting free text in individual electronic medical records. Structuring the medical narrative poses a significant challenge: content and level of detail are often unpredictable and vary per domain (and even per clinician). In an attempt to support structured recording of medical narratives we have developed OpenSDE (SDE: structured data entry). OpenSDE is intended for use in both care and research. Therefore, OpenSDE is designed to accommodate the structured recording of data in settings where content and order of data entry can often not be predicted. The aim of this research project is to investigate the feasibility of using data recorded with OpenSDE, for research purposes. Consistency and accuracy of collected data are pivotal for research, and are especially challenging if data will be collected over long periods of time and by different users. This Ph.D. project, therefore, focuses on pitfalls for data extraction for research purposes, and aims to formulate strategies to improve uniformity in data entry to enhance the reliability of data retrieval. In this research project we studied: • The possibility of extracting data recorded with OpenSDE and representing the extracted data in a manner suitable for research purposes. • The uniformity of recorded data when OpenSDE is used to transcribe data from the same source. • The origin of differences in representation of semantically identical information. • Strategies that can improve uniformity in data entry

Florida Undergraduate Research Conference

FURC serves as a multi-disciplinary conference through which undergraduate students from the state of Florida can present their research. February 16-17, 2024https://digitalcommons.unf.edu/university_events/1006/thumbnail.jp

Overhearing: An Attuning Approach to Noise in Danish Hospitals

Denmark is building new and improved super hospitals, based on a vision of improving overall quality by switching the focus from hospitals for treatment to hospitals for healing, guided by research in the field of evidence-based design and healing architecture. Users mention noise as one of the main stressors and research has discovered that noise levels in hospitals continue to rise. Noise has therefore become a central point of concern, recommending strategies to reduce measurable and perceived noise levels.However, these strategies do not support the need to feel like an integral part of the shared hospital environment, which is also a key element in creating healing environments linked to a reductionist framework underlying the field. This framework regards broad concepts such as noise and silence as objects with quantifiable properties, and assumes that these properties can be understood independently of the perceiver as a bodily and situated subject. The aim of this dissertation is accordingly to develop an alternative framework capable of accommodating the multi-sensory, affective and atmospheric conditions that influence the experience of noise, with a view to complementing the existing approaches in the field.  Consequently, the dissertation develops an ecological framework capable of accommodating these issues, established by viewing sound and listening through the lens of atmospheres. The attuning approach highlights the reciprocal relationship between the way in which atmospheres condition shared rhythms that shape us, but also the way in which we can tune them in different ways. In the context of sound and listening, this creates the potential of ecological overhearing as an atmospheric mode of listening capable of reconfiguring habitual background and foregrounding relationships. Attuning strategies should thus provide opportunities for diverse acoustic situations and possibilities for active choice-making to meet different and shifting needs through an enactive approach in order to enhance empowerment and ecological overhearing. Embedding diverse enactive sound installations and interactive sound technology in hospitals can facilitate such zones of overhearing. These zones become places for ruptures that strengthen the possibilities for engaging in counter-attunements of existing negative atmospheres. In this way, zones of overhearing not only provide continual sense of presence without demanding full attention, but also create ample opportunities for the restoration of  attention.The dissertation takes an experimental practice-based approach through artistic- and constructive design-research and comprises six peer-reviewed papers (Part IV), framed by a general overview article (Parts I-III) that develops the theoretical and methodological foundation for the papers, and provides a synthesis and discussion of their main findings. The practice-based work is founded on a range of experiments, but focuses on two main experiments: Light, Landscape & Voices and KidKit, and the way in which they elicit sensitivities within the topic of investigation. This contribution also concerns the concrete development of installations through the experiments. These installations are in themselves manifestations of and challenges to hypotheses about the topic I aim to address.

The Art of Performing Science

OCN 499 - Undergraduate Thesi