Health Information Privacy in the Correctional Environment

Information technology is considered a transformative element in health care because it facilitates the transparency and sharing of health information, which have always been central to the practice of medicine and the delivery of high-quality care. The widespread use of electronic health records (EHRs) and electronic health information exchange, among other technologies, is considered essential to improving the quality of care, reducing medical errors, reducing health disparities, and advancing the delivery of patient-centered medical care

Diagnosing Death: Why Does It Remain Well Settled and Persistently Unresolved ?

For ten days after Motl Brody had been declared dead by physicians, the 12-year-old boy lay in an intensive-care unit of Children\u27s National Medical Center, sustained by drugs and a ventilator. His Orthodox Jewish parents insisted that, according to religious law, Motl remained alive because his heart continued to beat. District of Columbia law said he did not. Although statutes on the books of every U.S. state allow a determination of death when all functions of the brain, including the brain stem, have irreversibly ceased, there is continued debate, especially in religious, philosophical, and bioethics contexts, about how, or even if, brain death should be defined. A new report by The George Washington University School of Public Health and Health Services (GW/SPHHS) offers an opportunity for health care providers, legislators and the general public to discuss the complexities of determining when death occurs. The report: Reviews the current legal definition(s) of death, based on either neurological or cardiovascular criteria, and how they evolved. Describes the distinction between a persistent vegetative state and brain death, explaining why a person whose body retains warmth, color, and some level of clinical functioning can nonetheless be considered dead. Considers arguments for a return to the exclusive use of a cardiovascular standard or a higher-brain standard built around the capacity for consciousness. Describes the debate over a statutory conscience clause, which allows personal choice regarding the determination of one\u27s death. Considers the uneasy relationship between the definition of death and the goal of increasing availability of organs for transplantation. The lack of consensus on an ontological question as profound as when death occurs is no surprise. Nonetheless, broader discussions may be appropriate to deepen public understanding and to create mechanisms to resolve the conflicts that will inevitably continue to arise

Data Segmentation in Electronic Health Information Exchange: Policy Considerations and Analysis

The issue of whether and, if so, to what extent patients should have control over the sharing or withholding of their health information represents one of the foremost policy challenges related to electronic health information exchange. It is widely acknowledged that patients\u27 health information should flow where and when it is needed to support the provision of appropriate and high-quality care. Equally significant, however, is the notion that patients want their needs and preferences to be considered in the determination of what information is shared with other parties, for what purposes, and under what conditions. Some patients may prefer to withhold or sequester certain elements of health information, often when it is deemed by them (or on their behalf) to be sensitive, whereas others may feel strongly that all of their health information should be shared under any circumstance. This discussion raises the issue of data segmentation, which we define for the purposes of this paper as the process of sequestering from capture, access or view certain data elements that are perceived by a legal entity, institution, organization, or individual as being undesirable to share. This whitepaper explores key components of data segmentation, circumstances for its use, associated benefits and challenges, various applied approaches, and the current legal environment shaping these endeavors

Health Information Technology in the United States: On the Cusp of Change, 2009

In this report we use the data collected for ONCHIT to focus on EHR adoption in the inpatient setting. We report on several important policy issues. These include the rate of adoption of EHRs among U.S. hospitals generally and among safety-net hospitals, changes in both state and federal policy, and the potential of EHRs to change the quality measurement enterprise

An Overview of Major Health Information Technology, Public Health, Medicaid, and COBRA Provisions of the American Recovery and Reinvestment Act of 2009

A detailed side-by-side analysis of the individual components of the American Recovery and Reinvestment Act of 2009 (ARRA), signed into law on February 17, 2009. One of the most sweeping pieces of economic legislation ever enacted, ARRA not only provides hundreds of billions of dollars in new health and health care spending but also makes comprehensive reforms in health law and policy, particularly in the area of health information law, including health information technology (HIT) adoption and health information privacy

An Overview of Major Health Provisions Contained in the American Recovery and Reinvestment Act of 2009

On February 17, 2009, President Barack Obama signed the American Recovery and Reinvestment Act of 2009 (ARRA) into law. One of the most sweeping pieces of economic legislation ever enacted, ARRA not only provides hundreds of billions of dollars in new health and health care spending but also makes comprehensive reforms in health law and policy, particularly in the area of health information law, including health information technology (HIT) adoption and health information privacy

Quality assurance and assessment frameworks of biosystems engineering studies

Regulatory instruments at the national level to ensure high quality are crucial to achieve and maintain a regional hub of higher education in Malta. While The Malta Qualifications Council and the National Commission for Higher Education are established and operational, the legal framework to set up a quality assurance agency and a quality assurance and licensing framework is in place, but the legislations is still awaiting approval. The University of Malta has set up internal quality assurance structures, The Programme Validation Committee monitors, reviews and recommends programmes for approval by Senate, The formation of the INSTITUTE OF EARTH SYSTEMS will facilitate the means through which a Bio Systems Engineering course could be offered, Furthermore the recent establishment of a Maltese Chamber of Agrologists could in theory eventually take up the role to grant professional accreditation,peer-reviewe

The Fermi GBM Gamma-Ray Burst Spectral Catalog: Four Years Of Data

In this catalog we present the updated set of spectral analyses of GRBs detected by the Fermi Gamma-Ray Burst Monitor (GBM) during its first four years of operation. It contains two types of spectra, time-integrated spectral fits and spectral fits at the brightest time bin, from 943 triggered GRBs. Four different spectral models were fitted to the data, resulting in a compendium of more than 7500 spectra. The analysis was performed similarly, but not identically to Goldstein et al. 2012. All 487 GRBs from the first two years have been re-fitted using the same methodology as that of the 456 GRBs in years three and four. We describe, in detail, our procedure and criteria for the analysis, and present the results in the form of parameter distributions both for the observer-frame and rest-frame quantities. The data files containing the complete results are available from the High-Energy Astrophysics Science Archive Research Center (HEASARC).Comment: Accepted for publication in ApJ

The 3rd Fermi GBM Gamma-Ray Burst Catalog: The First Six Years

Since its launch in 2008, the Fermi Gamma-ray Burst Monitor (GBM) has triggered and located on average approximately two gamma-ray bursts (GRB) every three days. Here we present the third of a series of catalogs of GRBs detected by GBM, extending the second catalog by two more years, through the middle of July 2014. The resulting list includes 1405 triggers identified as GRBs. The intention of the GBM GRB catalog is to provide information to the community on the most important observables of the GBM detected GRBs. For each GRB the location and main characteristics of the prompt emission, the duration, peak flux and fluence are derived. The latter two quantities are calculated for the 50-300~keV energy band, where the maximum energy release of GRBs in the instrument reference system is observed, and also for a broader energy band from 10-1000 keV, exploiting the full energy range of GBM's low-energy NaI(Tl) detectors. Using statistical methods to assess clustering, we find that the hardness and duration of GRBs are better fitted by a two-component model with short-hard and long-soft bursts, than by a model with three components. Furthermore, information is provided on the settings and modifications of the triggering criteria and exceptional operational conditions during years five and six in the mission. This third catalog is an official product of the Fermi GBM science team, and the data files containing the complete results are available from the High-Energy Astrophysics Science Archive Research Center (HEASARC).Comment: 225 pages, 13 figures and 8 tables. Accepted for publication in Astrophysical Journal Supplement 201

First-year Results of Broadband Spectroscopy of the Brightest Fermi-GBM Gamma-Ray Bursts

We present here our results of the temporal and spectral analysis of a sample of 52 bright and hard gamma-ray bursts (GRBs) observed with the Fermi Gamma-ray Burst Monitor (GBM) during its first year of operation (July 2008-July 2009). Our sample was selected from a total of 253 GBM GRBs based on each event peak count rate measured between 0.2 and 40MeV. The final sample comprised 34 long and 18 short GRBs. These numbers show that the GBM sample contains a much larger fraction of short GRBs, than the CGRO/BATSE data set, which we explain as the result of our (different) selection criteria and the improved GBM trigger algorithms, which favor collection of short, bright GRBs over BATSE. A first by-product of our selection methodology is the determination of a detection threshold from the GBM data alone, above which GRBs most likely will be detected in the MeV/GeV range with the Large Area Telescope (LAT) onboard Fermi. This predictor will be very useful for future multiwavelength GRB follow ups with ground and space based observatories. Further we have estimated the burst durations up to 10MeV and for the first time expanded the duration-energy relationship in the GRB light curves to high energies. We confirm that GRB durations decline with energy as a power law with index approximately -0.4, as was found earlier with the BATSE data and we also notice evidence of a possible cutoff or break at higher energies. Finally, we performed time-integrated spectral analysis of all 52 bursts and compared their spectral parameters with those obtained with the larger data sample of the BATSE data. We find that the two parameter data sets are similar and confirm that short GRBs are in general harder than longer ones.Comment: 40 pages, 11 figures, 3 tables, Submitted to Ap