A Communicative Landscape of Health Information Needs for Malaria Management in the Millennium Villages Project in Bonsaaso, Ghana

We performed a qualitative study (n=39) mapping the health information needs of stakeholders involved with malaria prevention and treatment in rural Ghana as part of a larger effort to develop integrated, scalable eHealth tools. Initial results can be categorized into four areas: health care delivery, data quality, technical problems and workforce-related problems. This comprehensive review of information challenges in one area identifies fertile ground for potential improvement using health information technology

Small-Scale Hydroelectric Power for Remote Communities

The Pico-Hydro Energy Project (PHEP) focuses on providing affordable electric power for off-grid communities in developing countries. The work that PHEP is doing involves the design, optimization, and experimental testing of small hydroelectric generators provided by our project partner Engineering Ministries International.https://mosaic.messiah.edu/engr2020/1000/thumbnail.jp

Evaluation of a Concept Mapping Task Using Named Entity Recognition and Normalization in Unstructured Clinical Text.

In this pilot study, we explore the feasibility and accuracy of using a query in a commercial natural language processing engine in a named entity recognition and normalization task to extract a wide spectrum of clinical concepts from free text clinical letters. Editorial guidance developed by two independent clinicians was used to annotate sixty anonymized clinic letters to create the gold standard. Concepts were categorized by semantic type, and labels were applied to indicate contextual attributes such as negation. The natural language processing (NLP) engine was Linguamatics I2E version 5.3.1, equipped with an algorithm for contextualizing words and phrases and an ontology of terms from Intelligent Medical Objects to which those tokens were mapped. Performance of the engine was assessed on a training set of the documents using precision, recall, and the F1 score, with subset analysis for semantic type, accurate negation, exact versus partial conceptual matching, and discontinuous text. The engine underwent tuning, and the final performance was determined for a test set. The test set showed an F1 score of 0.81 and 0.84 using strict and relaxed criteria respectively when appropriate negation was not required and 0.75 and 0.77 when it was. F1 scores were higher when concepts were derived from continuous text only. This pilot study showed that a commercially available NLP engine delivered good overall results for identifying a wide spectrum of structured clinical concepts. Such a system holds promise for extracting concepts from free text to populate problem lists or for data mining projects

Exploring the Consistency, Quality and Challenges in Manual and Automated Coding of Free-text Diagnoses from Hospital Outpatient Letters

Coding of unstructured clinical free-text to produce interoperable structured data is essential to improve direct care, support clinical communication and to enable clinical research.However, manual clinical coding is difficult and time consuming, which motivates the development and use of natural language processing for automated coding. This work evaluates the quality and consistency of both manual and automated clinical coding of diagnoses from hospital outpatient letters. Using 100 randomly selected letters, two human clinicians performed coding of diagnosis lists to SNOMED CT. Automated coding was also performed using IMO's Concept Tagger. A gold standard was constructed by a panel of clinicians from a subset of the annotated diagnoses. This was used to evaluate the quality and consistency of both manual and automated coding via (1) a distance-based metric, treating SNOMED CT as a graph, and (2) a qualitative metric agreed upon by the panel of clinicians. Correlation between the two metrics was also evaluated. Comparing human and computer-generated codes to the gold standard, the results indicate that humans slightly out-performed automated coding, while both performed notably better when there was only a single diagnosis contained in the free-text description. Automated coding was considered acceptable by the panel of clinicians in approximately 90% of cases

Development and Deployment of the OpenMRS-Ebola Electronic Health Record System for an Ebola Treatment Center in Sierra Leone.

BACKGROUND: Stringent infection control requirements at Ebola treatment centers (ETCs), which are specialized facilities for isolating and treating Ebola patients, create substantial challenges for recording and reviewing patient information. During the 2014-2016 West African Ebola epidemic, paper-based data collection systems at ETCs compromised the quality, quantity, and confidentiality of patient data. Electronic health record (EHR) systems have the potential to address such problems, with benefits for patient care, surveillance, and research. However, no suitable software was available for deployment when large-scale ETCs opened as the epidemic escalated in 2014. OBJECTIVE: We present our work on rapidly developing and deploying OpenMRS-Ebola, an EHR system for the Kerry Town ETC in Sierra Leone. We describe our experience, lessons learned, and recommendations for future health emergencies. METHODS: We used the OpenMRS platform and Agile software development approaches to build OpenMRS-Ebola. Key features of our work included daily communications between the development team and ground-based operations team, iterative processes, and phased development and implementation. We made design decisions based on the restrictions of the ETC environment and regular user feedback. To evaluate the system, we conducted predeployment user questionnaires and compared the EHR records with duplicate paper records. RESULTS: We successfully built OpenMRS-Ebola, a modular stand-alone EHR system with a tablet-based application for infectious patient wards and a desktop-based application for noninfectious areas. OpenMRS-Ebola supports patient tracking (registration, bed allocation, and discharge); recording of vital signs and symptoms; medication and intravenous fluid ordering and monitoring; laboratory results; clinician notes; and data export. It displays relevant patient information to clinicians in infectious and noninfectious zones. We implemented phase 1 (patient tracking; drug ordering and monitoring) after 2.5 months of full-time development. OpenMRS-Ebola was used for 112 patient registrations, 569 prescription orders, and 971 medication administration recordings. We were unable to fully implement phases 2 and 3 as the ETC closed because of a decrease in new Ebola cases. The phase 1 evaluation suggested that OpenMRS-Ebola worked well in the context of the rollout, and the user feedback was positive. CONCLUSIONS: To our knowledge, OpenMRS-Ebola is the most comprehensive adaptable clinical EHR built for a low-resource setting health emergency. It is designed to address the main challenges of data collection in highly infectious environments that require robust infection prevention and control measures and it is interoperable with other electronic health systems. Although we built and deployed OpenMRS-Ebola more rapidly than typical software, our work highlights the challenges of having to develop an appropriate system during an emergency rather than being able to rapidly adapt an existing one. Lessons learned from this and previous emergencies should be used to ensure that a set of well-designed, easy-to-use, pretested health software is ready for quick deployment in future

Mobile phones and social structures: an exploration of a closed user group in rural Ghana

Background: In the Millennium Villages Project site of Bonsaaso, Ghana, the Health Team is using a mobile phone closed user group to place calls amongst one another at no cost. Methods: In order to determine the utilization and acceptability of the closed user group amongst users, social network analysis and qualitative methods were used. Key informants were identified and interviewed. The key informants also kept prospective call journals. Billing statements and de-identified call data from the closed user group were used to generate data for analyzing the social structure revealed by the network traffic. Results: The majority of communication within the closed user group was personal and not for professional purposes. The members of the CUG felt that the group improved their efficiency at work. Conclusions: The methods used present an interesting way to investigate the social structure surrounding communication via mobile phones. In addition, the benefits identified from the exploration of this closed user group make a case for supporting mobile phone closed user groups amongst professional groups

Picosecond Synchronization of Photon Pairs through a Fiber Link between Fermilab and Argonne National Laboratories

We demonstrate a three-node quantum network for C-band photon pairs using 2 pairs of 59 km of deployed fiber between Fermi and Argonne National Laboratories. The C-band pairs are directed to nodes using a standard telecommunication switch and synchronized to picosecond-scale timing resolution using a coexisting O- or L-band optical clock distribution system. We measure a reduction of coincidence-to-accidental ratio (CAR) of the C-band pairs from 51 $\pm$ 2 to 5.3 $\pm$ 0.4 due to Raman scattering of the O-band clock pulses. Despite this reduction, the CAR is nevertheless suitable for quantum networks

Italian and English local funding networks: Is there a winning formula?

This article contributes to the understanding of European Local Governance by exploring the European funding networks developed within local areas under Objective 2 of the Structural Funds. The article describes the EU funding networks (within the theoretical perspective of network theory) and examines the relationship between the presence of local EU funding networks and councils' success in accessing EU funds. This exploratory study focuses on the appearance of policy networks at the local government level in Italy and England and discusses their durability and implications for their future