Information systems in support of public health in high-income countries

2021 ◽  
pp. 3-12
Author(s):  
Tjeerd-Pieter van Staa ◽  
Liam Smeeth
Keyword(s):  
Public Health ◽  
Information Systems ◽  
Disease Surveillance ◽  
Point Of Care ◽  
Clinical Care ◽  
Healthcare Providers ◽  
Clinical Information ◽  
Evidence Base ◽  
Healthcare Intervention ◽  
Healthcare Interventions

Public health activities are dependent on the availability of information and ability to disseminate information to clinicians/healthcare providers, individuals, and communities. The increasing computerization of healthcare systems can offer opportunities to improve these activities. Databases of electronic healthcare records are used for disease surveillance and monitoring healthcare interventions. The quality and quantity of reporting of notifiable diseases may be improved by regular review of the electronic healthcare records. Randomized trials that recruit patients at the point of care and use electronic healthcare records for collection of follow-up information can be used to test the effectiveness of healthcare intervention in routine clinical practice. Cluster trials that randomize different clinics or regions can compare different public health policies and improve the evidence base for the pragmatic use of public health interventions. Data generated within clinical information systems can be used to provide feedback and guidance to clinicians and patients as part of clinical care. Better information systems providing data on risks and benefits of healthcare interventions will provide an important impetus to evidence-based public health.

scholarly journals The Clinical Information Systems Response to the COVID-19 Pandemic

2021 ◽  
Vol 30 (01) ◽  
pp. 105-125
Author(s):  
J. Jeffery Reeves ◽  
Natalie M. Pageler ◽  
Elizabeth C. Wick ◽  
Genevieve B. Melton ◽  
Yu-Heng Gamaliel Tan ◽  
...  
Keyword(s):  
Information Systems ◽  
Information Exchange ◽  
Large Scale ◽  
Predictive Analytics ◽  
Clinical Care ◽  
Clinical Information ◽  
Machine Learning Algorithms ◽  
Screening Tools ◽  
Contact Tracing ◽  
Clinical Information Systems

Summary Objective: The year 2020 was predominated by the coronavirus disease 2019 (COVID-19) pandemic. The objective of this article is to review the areas in which clinical information systems (CIS) can be and have been utilized to support and enhance the response of healthcare systems to pandemics, focusing on COVID-19. Methods: PubMed/MEDLINE, Google Scholar, the tables of contents of major informatics journals, and the bibliographies of articles were searched for studies pertaining to CIS, pandemics, and COVID-19 through October 2020. The most informative and detailed studies were highlighted, while many others were referenced. Results: CIS were heavily relied upon by health systems and governmental agencies worldwide in response to COVID-19. Technology-based screening tools were developed to assist rapid case identification and appropriate triaging. Clinical care was supported by utilizing the electronic health record (EHR) to onboard frontline providers to new protocols, offer clinical decision support, and improve systems for diagnostic testing. Telehealth became the most rapidly adopted medical trend in recent history and an essential strategy for allowing safe and effective access to medical care. Artificial intelligence and machine learning algorithms were developed to enhance screening, diagnostic imaging, and predictive analytics - though evidence of improved outcomes remains limited. Geographic information systems and big data enabled real-time dashboards vital for epidemic monitoring, hospital preparedness strategies, and health policy decision making. Digital contact tracing systems were implemented to assist a labor-intensive task with the aim of curbing transmission. Large scale data sharing, effective health information exchange, and interoperability of EHRs remain challenges for the informatics community with immense clinical and academic potential. CIS must be used in combination with engaged stakeholders and operational change management in order to meaningfully improve patient outcomes. Conclusion: Managing a pandemic requires widespread, timely, and effective distribution of reliable information. In the past year, CIS and informaticists made prominent and influential contributions in the global response to the COVID-19 pandemic.

scholarly journals Recent Advancement of Clinical Information Systems: Opportunities and Challenges

2018 ◽  
Vol 27 (01) ◽  
pp. 083-090 ◽  
Author(s):  
Md. Mohaimenul Islam ◽  
Tahmina Nasrin Poly ◽  
Yu-Chuan Li
Keyword(s):  
Information Systems ◽  
Patient Information ◽  
Data Exchange ◽  
Healthcare Providers ◽  
Diagnostic Errors ◽  
Clinical Information ◽  
Organizational Factors ◽  
Field Studies ◽  
Quality Of Healthcare ◽  
Clinical Information Systems

Objectives: Clinical information systems (CISs) have generated opportunities for meaningful improvements both in patient care and workflow but there is still a long way to perfection. Healthcare providers are still facing challenges of data exchange, management, and integration due to lack of functionality among these systems. Our objective here is to systematically review, synthesize, and summarize the literature that describes the current stage of clinical information systems, so as to assess the current state of knowledge, and identify benefits and challenges. Methods: PubMed, EMBASE, and the bibliographies of articles were searched for studies published until September 1, 2017, which reported on significant advancement of clinical information systems, as well as problems and opportunities in this field. Studies providing the most detailed information were included and the others were kept only as references. Results: We selected 23 papers out of 1,026 unique abstracts for full-text review using our selection criteria, and 20 out of these 23 studies met all of our inclusion criteria. We focused on three major areas: 1) Ambulatory and inpatients clinical information systems; 2) Specialty information systems; and 3) Ancillary information systems. As CIS can support evidence-based practices that, in turn, improve patient's safety, quality and efficacy of care, advancement, acceptability, and adaptability of CIS have increased worldwide. Although, the demand for CIS functionality is rising fast, current CISs still have data integration challenges and lack of functionality to exchange patient information from all or some parts of the healthcare system. These limitations can be attributed to technical, human, and organizational factors Conclusion: Clinical information systems provide tremendous opportunities to reduce clinical errors such as medication errors and diagnostic errors and to support healthcare professionals by offering up-to-date patient information. They promise to improve workflow and efficiency of care, thus boosting the overall quality of healthcare.

Tools and Considerations to Develop the Blueprint for the Next Generation of Clinical Care Technology

2019 ◽  
Vol 8 (1) ◽  
pp. 1-8
Author(s):  
Chris Daniel Riha
Keyword(s):  
Information Systems ◽  
Clinical Care ◽  
Clinical Decision Support Systems ◽  
Clinical Information ◽  
Clinical Decision ◽  
Clinical Engineering ◽  
Historical Background ◽  
Clinical Information Systems ◽  
Next Generation ◽  
Care Technology

This article provides a brief historical look at the genesis and evolution of clinical information systems. Based upon this historical background and the expertise of the authors, which encompasses, clinical, IT/cybersecurity, clinical engineering, as well as quality control expertise the article provides a roadmap for the next generation of clinical information systems. This next generation will not only provide consulting services to physicians via computer clinical decision support systems, but also the ability to perform autonomous and semi-autonomous care at the bedside via interfaces to medical devices (e.g. ventilators and infusion pumps), as well as auto ordering protocols.

Optimizing the Use and Adoption of Healthcare Information Systems

2017 ◽  
pp. 49-61
Author(s):  
Wilfred Bonney
Keyword(s):  
Information Systems ◽  
Translational Research ◽  
Medical Records ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Clinical Information ◽  
Healthcare Information ◽  
Health Records ◽  
Healthcare Information Systems ◽  
Information And Communication

Advancements in Information and Communication Technology (ICT) have led to the development of various forms of electronic records to support general practitioners and healthcare providers in capturing, storing, and retrieving routinely collected medical records and/or clinical information for optimal primary care and translational research. These advancements have resulted in the emergence of interoperable Healthcare Information Systems (HIS) such as Electronic Health Records (EHRs), Electronic Medical Records (EMRs) and Personal Health Records (PHRs). However, even as these systems continue to evolve, the research community is interested in understanding how the use and adoption of HIS can be optimized to support effective and efficient healthcare delivery and translational research. In this chapter, a systematic literature review methodology was used not only to explore the key benefits and technical challenges of HIS, but also to discuss the optimization approaches to maximizing the use and adoption of HIS in healthcare delivery.

scholarly journals New technologies for reporting real-time emergent infections

Parasitology ◽  
2012 ◽  
Vol 139 (14) ◽  
pp. 1843-1851 ◽  
Author(s):  
RUMI CHUNARA ◽  
CLARK C. FREIFELD ◽  
JOHN S. BROWNSTEIN
Keyword(s):  
Public Health ◽  
Mobile Phones ◽  
Disease Surveillance ◽  
New Technologies ◽  
Point Of Care ◽  
Diagnostic Tools ◽  
Microfluidic Chips ◽  
New Paradigm ◽  
Novel Technologies ◽  
Epidemic Intelligence

SUMMARYNovel technologies have prompted a new paradigm in disease surveillance. Advances in computation, communications and materials enable new technologies such as mobile phones and microfluidic chips. In this paper we illustrate examples of new technologies that can augment disease detection. We describe technologies harnessing the internet, mobile phones, point of care diagnostic tools and methods that facilitate detection from passively collected unstructured data. We demonstrate how these can all assist in quicker detection, investigation and response to emerging infectious events. Novel technologies enable collection and dissemination of epidemic intelligence data to both public health practitioners and the general public, enabling finer temporal and spatial resolution of disease monitoring than through traditional public health processes.

scholarly journals Diagnostic Justice

2021 ◽  
Vol 17 (2) ◽  
Author(s):  
Ashley Graham Kennedy ◽  
Bryan Cwik
Keyword(s):  
Public Health ◽  
Clinical Research ◽  
Disease Surveillance ◽  
Ethical Issues ◽  
Clinical Care ◽  
Diagnostic Testing ◽  
Trial Participation ◽  
Ethical Considerations ◽  
Randomized Controlled ◽  
Active Surveillance Testing

Diagnostic testing can be used for many purposes, including testing to facilitate the clinical care of individual patients, testing as an inclusion criterion for clinical trial participation, and both passive and active surveillance testing of the general population in order to facilitate public health outcomes, such as the containment or mitigation of an infectious disease. As such, diagnostic testing presents us with ethical questions that are, in part, already addressed in the literature on clinical care as well as clinical research (such as the rights of patients to refuse testing or treatment in the clinical setting or the rights of participants in randomized controlled trials to withdraw from the trial at any time). However, diagnostic testing, for the purpose of disease surveillance also raises ethical issues that we do not encounter in these settings, and thus have not been much discussed. In this paper we will be concerned with the similarities and differences between the ethical considerations in these three domains: clinical care, clinical research, and public health, as they relate to diagnostic testing specifically. Via an examination of the COVID-19 case we will show how an appeal to the concept of diagnostic justice helps us to make sense of the (at times competing) ethical considerations in these three domains.

Optimizing the Use and Adoption of Healthcare Information Systems

2016 ◽  
pp. 136-152 ◽  
Author(s):  
Wilfred Bonney
Keyword(s):  
Information Systems ◽  
Translational Research ◽  
Medical Records ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Clinical Information ◽  
Healthcare Information ◽  
Health Records ◽  
Healthcare Information Systems ◽  
Information And Communication

Advancements in Information and Communication Technology (ICT) have led to the development of various forms of electronic records to support general practitioners and healthcare providers in capturing, storing, and retrieving routinely collected medical records and/or clinical information for optimal primary care and translational research. These advancements have resulted in the emergence of interoperable Healthcare Information Systems (HIS) such as Electronic Health Records (EHRs), Electronic Medical Records (EMRs) and Personal Health Records (PHRs). However, even as these systems continue to evolve, the research community is interested in understanding how the use and adoption of HIS can be optimized to support effective and efficient healthcare delivery and translational research. In this chapter, a systematic literature review methodology was used not only to explore the key benefits and technical challenges of HIS, but also to discuss the optimization approaches to maximizing the use and adoption of HIS in healthcare delivery.

scholarly journals Public health reporting and outbreak response: synergies with evolving clinical standards for interoperability

2020 ◽  
Vol 27 (7) ◽  
pp. 1136-1138 ◽  
Author(s):  
Ninad K Mishra ◽  
Jon Duke ◽  
Leslie Lenert ◽  
Saugat Karki
Keyword(s):  
Public Health ◽  
Fast Moving ◽  
Disease Surveillance ◽  
Health Workers ◽  
Clinical Information ◽  
Patient Privacy ◽  
Outbreak Response ◽  
Healthcare Resources ◽  
Public Health Reporting ◽  
Application Programming

Abstract Public health needs up-to-date information for surveillance and response. As healthcare application programming interfaces become widely available, a novel data gathering mechanism could provide public health with critical information in a timely fashion to respond to a fast-moving epidemic. In this article, we extrapolate from our experiences using a Fast Healthcare Interoperability Resource-based architecture for infectious disease surveillance for sexually transmitted diseases to its application to gather case information for an outbreak. One of the challenges with a fast-moving outbreak is to accurately assess its demand on healthcare resources, since information specific to comorbidities is often not available. These comorbidities are often associated with poor prognosis and higher resource utilization. If the comorbidity data and other clinical information were readily available to public health workers, they could better address community disruption and manage healthcare resources. The use of FHIR resources available through application programming and filtered through tools such as described herein will give public health the flexibility needed to investigate rapidly emerging disease while protecting patient privacy.

scholarly journals The Controversies, Challenges and Complexities of Lyme Disease: A Narrative Review

2018 ◽  
Vol 21 ◽  
pp. 429-436 ◽  
Author(s):  
Marie Claire Van Hout
Keyword(s):  
Public Health ◽  
Lyme Disease ◽  
Clinical Care ◽  
Evidence Base ◽  
Narrative Review ◽  
Health Concern ◽  
Future Research ◽  
Global Public Health ◽  
Broad Perspective ◽  
History Of

Purpose: Lyme disease has become an increasingly important global public health concern. Method: A narrative review was conducted and designed to present a broad perspective on Lyme disease, and describe its history and development in terms of clinical care and public health implications. A structured literature search was conducted based on the question; what is currently known about Lyme disease? Results: The narrative review is presented in chronological order in terms of a summary of the history of Lyme disease, the complexities of clinical diagnosis, the problematic interpretation of serologic testing, the conflicting guidelines for diagnosis, treatment and management of chronic Lyme, and benefits of antibiotic treatment. Conclusion: Despite growing global incidence of the Lyme disease, treatment has not attracted pharmaceutical investment, and the evidence base and international guidelines for treatment and management of chronic Lyme continue to be conflicting and controversial. The challenges of this immune mediated tick borne disease for public health policy and clinical practice are summarised, alongside directions for future research.

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