Secondary uses of patient information

Summary Objectives: To provide an introduction to the 2017 IMIA Yearbook of Medical Informatics by the editors. Methods: We present a brief overview of the 2017 special topic “Learning from experience: Secondary use of patient data”. We review our choice of special topic section editors, present the new section “Health Information Management”, and discuss transitions in the editorial team. Results: In this edition of the Yearbook, we focused on one of the most important issues for the medical informatics community: The secondary use of clinical data. With the ubiquitous adoption of electronic health records (EHRs) and the increasing availability of genomic and environmental data, as well as the accessibility of unstructured data in social media, issues related to data integration, storage, and management, as well as the need for novel analytic approaches are clear challenges. The paradigm of Learning Health Systems (LHSs) is presented in the keynote paper and survey papers review the significant developments in allied fields such as clinical research, clinical systems, translational informatics, and public health over the past two years. IMIA Working Groups also contributed to this topic. Conclusion: The 2017 issue of the IMIA yearbook focuses on the secondary use of patient data and presents the difficulties that still need to be solved before witnessing the actual development of LHSs.

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Transforming Data into Knowledge: How to Improve the Efficiency of Clinical Care?

Yearbook of Medical Informatics ◽

10.1055/s-0038-1637768 ◽

2017 ◽

Vol 26 (01) ◽

pp. 4-6

Author(s):

B. Séroussi ◽

L. F. Soualmia ◽

J. H. Holmes

Keyword(s):

Medical Informatics ◽

Clinical Care ◽

Patient Data ◽

Environmental Data ◽

Editorial Team ◽

Special Topic ◽

Learning From Experience ◽

Secondary Use ◽

Working Groups ◽

Translational Informatics

Summary Objectives: To provide an introduction to the 2017 IMIA Yearbook of Medical Informatics by the editors. Methods: We present a brief overview of the 2017 special topic “Learning from experience: Secondary use of patient data”. We review our choice of special topic section editors, present the new section “Health Information Management”, and discuss transitions in the editorial team. Results: In this edition of the Yearbook, we focused on one of the most important issues for the medical informatics community: The secondary use of clinical data. With the ubiquitous adoption of electronic health records (EHRs) and the increasing availability of genomic and environmental data, as well as the accessibility of unstructured data in social media, issues related to data integration, storage, and management, as well as the need for novel analytic approaches are clear challenges. The paradigm of Learning Health Systems (LHSs) is presented in the keynote paper and survey papers review the significant developments in allied fields such as clinical research, clinical systems, translational informatics, and public health over the past two years. IMIA Working Groups also contributed to this topic. Conclusion: The 2017 issue of the IMIA yearbook focuses on the secondary use of patient data and presents the difficulties that still need to be solved before witnessing the actual development of LHSs.

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Normative Aspects of Nudging in the International Sphere

AJIL Unbound ◽

10.1017/aju.2021.35 ◽

2021 ◽

Vol 115 ◽

pp. 263-267

Author(s):

Doron Teichman ◽

Eyal Zamir

Keyword(s):

Energy Consumption ◽

Organ Donation ◽

Low Cost ◽

National Level ◽

The Past ◽

The People ◽

Posthumous Organ Donation ◽

Regulatory Problems

The use of nudges—“low-cost, choice-preserving, behaviorally informed approaches to regulatory problems”—has become quite popular at the national level in the past decade or so. Examples include changing the default concerning employees’ saving for retirement in a bid to encourage such saving; altering the default about consent to posthumous organ donation to increase the supply of organs for transplantation; and informing people about other people's energy consumption to spur them to reduce theirs. Nudges are therefore used to promote the welfare of the people being nudged, and of society at large. However, the use of nudges has sparked a lively normative debate. When turning to the international arena, new arguments for and against nudges can be raised. This essay focuses on the normative aspects of using nudges in the international arena.

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The academic viewpoint on Big data and patient data ownership (as seen in the scientific literature)

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.171 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

I Mircheva ◽

M Mirchev

Keyword(s):

Public Health ◽

Big Data ◽

Medical Research ◽

Information And Communication Technologies ◽

Patient Information ◽

Scientific Literature ◽

Medical Data ◽

Patient Data ◽

Academic Community ◽

Ethical Challenges

Abstract Background Ownership of patient information in the context of Big Data is a relatively new problem, apparently not yet fully understood. There are not enough publications on the subject. Since the topic is interdisciplinary, incorporating legal, ethical, medical and aspects of information and communication technologies, a slightly more sophisticated analysis of the issue is needed. Aim To determine how the medical academic community perceives the issue of ownership of patient information in the context of Big Data. Methods Literature search for full text publications, indexed in PubMed, Springer, ScienceDirect and Scopus identified only 27 appropriate articles authored by academicians and corresponding to three focus areas: problem (ownership); area (healthcare); context (Big Data). Three major aspects were studied: scientific area of publications, aspects and academicians' perception of ownership in the context of Big Data. Results Publications are in the period 2014 - 2019, 37% published in health and medical informatics journals, 30% in medicine and public health, 19% in law and ethics; 78% authored by American and British academicians, highly cited. The majority (63%) are in the area of scientific research - clinical studies, access and use of patient data for medical research, secondary use of medical data, ethical challenges to Big data in healthcare. The majority (70%) of the publications discuss ownership in ethical and legal aspects and 67% see ownership as a challenge mostly to medical research, access control, ethics, politics and business. Conclusions Ownership of medical data is seen first and foremost as a challenge. Addressing this challenge requires the combined efforts of politicians, lawyers, ethicists, computer and medical professionals, as well as academicians, sharing these efforts, experiences and suggestions. However, this issue is neglected in the scientific literature. Publishing may help in open debates and adequate policy solutions. Key messages Ownership of patient information in the context of Big Data is a problem that should not be marginalized but needs a comprehensive attitude, consideration and combined efforts from all stakeholders. Overcoming the challenge of ownership may help in improving healthcare services, medical and public health research and the health of the population as a whole.

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Sonographic Evaluation of Hidradenitis Suppurativa with Smartphone-Linked Portable Ultrasound

Dermatology ◽

10.1159/000513920 ◽

2021 ◽

pp. 1-5

Author(s):

Maximillian A. Weigelt ◽

Yuval Hilerowicz ◽

Jeffrey A. Leichter ◽

Hadar Lev-Tov

Keyword(s):

Hidradenitis Suppurativa ◽

Wound Care ◽

University Hospital ◽

Clinical Staging ◽

Routine Practice ◽

Portable Ultrasound ◽

Number Of Patients ◽

Staging Systems ◽

Conventional Ultrasound ◽

Potential Benefits

Background: Clinical staging systems for hidradenitis suppurativa (HS) have poor interrater reliability and may underestimate disease activity. Sonographic staging systems may overcome these challenges, but conventional ultrasound (US) machines are expensive and bulky. Portable (p)US may facilitate the integration of sonography into routine practice. Objectives: To assess the ability of a novel smartphone-linked pUS device to identify key sonographic lesions of HS. Methods: The charts of 16 patients with HS who were assessed with pUS at the outpatient Dermatology and Wound Care Clinics of a university hospital center were retrospectively reviewed. Clinical and sonographic images of the affected areas were examined. The main outcome measures were the number of patients with identifiable sonographic lesions and the number of patients with subclinical lesions detected by pUS. Results: All 3 key sonographic lesions of HS were identifiable with pUS. Sonographic lesions were identified in 10 patients (62.5%). Subclinical lesions were identified in 2 patients (12.5%); in both cases, this affected management decisions. Conclusions: We demonstrate the ability of pUS to identify the key sonographic lesions of HS. pUS is a simple and affordable way to integrate HSUS into clinical and research settings, with clear potential benefits to patients.

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Psychology Staffing at Cancer Centers: Data From National Comprehensive Cancer Network Member Institutions

JCO Oncology Practice ◽

10.1200/op.20.00087 ◽

2020 ◽

Vol 16 (11) ◽

pp. e1343-e1354

Author(s):

Laura Melton ◽

Diana Krause ◽

Jessica Sugalski

Keyword(s):

National Comprehensive Cancer Network ◽

Patient Care ◽

Clinical Care ◽

The United States ◽

Direct Patient Care ◽

Cancer Center ◽

Network Member ◽

Full Time ◽

Cancer Centers ◽

Cancer Network

PURPOSE: The field of psycho-oncology is relatively undeveloped, with little information existing regarding the use of psychologists at cancer centers. Comprising 30 leading cancer centers across the United States, the National Comprehensive Cancer Network (NCCN) set out to understand the trends in its Member Institutions. METHODS: The NCCN Best Practices Committee surveyed NCCN Member Institutions regarding their use of psychologists. The survey was administered electronically in the spring/summer of 2017. RESULTS: The survey was completed by 18 cancer centers. Across institutions, 94% have psychologists appointed to provide direct care to their cancer center patients. The number of licensed psychologist full-time equivalents (FTEs) on staff who provide direct patient care ranged from < 1.0 FTE (17%) to 17.0-17.9 FTEs (6%). Regarding psychologist appointments, 41% have both faculty and staff appointments, 41% have all faculty appointments, and 18% have all staff appointments. Forty-three percent of institutions indicated that some licensed psychologists at their centers (ranging from 1%-65%) do not provide any direct clinical care, and 57% indicated that all licensed psychologist on staff devote some amount of time to direct clinical care. The percent of clinical care time that is spent on direct clinical care ranged from 15%-90%. CONCLUSION: There is great variability in psychology staffing, academic appointments, and the amount of direct patient care provided by on-staff psychologists at cancer centers.

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Managing the Digital Disruption Associated with COVID-19-Driven Rapid Digital Transformation in Brisbane, Australia

Applied Clinical Informatics ◽

10.1055/s-0041-1740190 ◽

2021 ◽

Vol 12 (05) ◽

pp. 1135-1143

Author(s):

Amalie Dyda ◽

Magid Fahim ◽

Jon Fraser ◽

Marianne Kirrane ◽

Ides Wong ◽

...

Keyword(s):

Care Delivery ◽

Digital Health ◽

Clinical Care ◽

Models Of Care ◽

Digital Transformation ◽

Lessons Learned ◽

Digital Data ◽

Routine Practice ◽

Action Research Project ◽

Digital Disruption

Abstract Background The COVID-19 pandemic has forced rapid digital transformation of many health systems. These innovations are now entering the literature, but there is little focus on the resulting disruption. Objective We describe the implementation of digital innovations during the COVID-19 response of Australia's largest health service, Metro North (in Brisbane, Queensland), the challenges of the subsequent digital disruption, how these were managed, and lessons learned. Methods Prior to the COVID-19 pandemic, the Australian state of Queensland created the Queensland Digital Clinical Charter, which provides guidance for the development of digital health programs. The guidelines utilize three horizons: digitizing workflows, leveraging digital data to transform clinical care, and reimagining new and innovative models of care. The technical response to COVID-19 in Metro North is described across these horizons. The rapid digital response caused significant disruption to health care delivery; management of the disruption and the outcomes are detailed. This is a participatory action research project, with members of the research team assisting with leading the implementation project informing the case report content. Results Several digital innovations were introduced across Metro North during the COVID-19 response. This resulted in significant disruption creating digital hypervigilance, digital deceleration, data discordance, and postdigital “depression.” Successful management of the digital disruption minimized the negative effects of rapid digital transformation, and contributed to the effective management of the pandemic in Queensland. Conclusion The rapid digital transformation in Metro North during COVID-19 was successful in several aspects; however, ongoing challenges remain. These include the need to improve data sharing and increase interoperability. Importantly, the innovations need to be evaluated to ensure that Metro North can capitalize on these changes and incorporate them into long-term routine practice. Moving forward, it will be essential to manage not only the pandemic, but increasingly, the resultant digital disruption.

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Regulatory Administration: An Evolving and Neglected Area of Public Administration in India

Indian Journal of Public Administration ◽

10.1177/0019556118783064 ◽

2018 ◽

Vol 64 (4) ◽

pp. 686-702

Author(s):

Yudhishthira Sapru ◽

R.K. Sapru

Keyword(s):

National Level ◽

Current Phase ◽

The Public ◽

The People ◽

Policies And Procedures ◽

Governance Process ◽

Regulatory Bodies ◽

The Government ◽

Political Economic ◽

And Control

In the current phase of liberalisation, privatisation and globalisation, and now broadly governance, regulatory administration has acquired growing importance as an instrument of achieving socio-economic objectives. It is through instrumentality of regulatory administration that the government is able to exercise effective political and economic sovereignty and control over the country’s governance process and resources. Governments of nearly all developing countries have initiated policies and procedures to promote and strengthen regulatory bodies and agencies. However, the results of these promotional and regular activities have varied considerably, often reflecting large inadequacies in policies, organisational structures and procedures. Increasing emphasis is now being placed at the national level on a more flexible regulatory administration to enforce compliance with nationally established policies and requirements in various political, economic and social spheres. As a watchdog for the public interest, governments both at central and state levels should engage in activities for the promotion of social and economic justice, so as to ensure the happiness and prosperity of the people.

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Limiting transmission of COVID-19 in an inpatient psychiatric hospital using a special care unit as a behavioral health model - Michigan, March 1-August 31, 2020

Journal of Hospital Administration ◽

10.5430/jha.v10n3p25 ◽

2021 ◽

Vol 10 (3) ◽

pp. 25

Author(s):

William Sanders ◽

Kimberley Greenwald ◽

Joshua Foster ◽

David Meisinger ◽

Richelle Payea ◽

...

Keyword(s):

Health Care ◽

Patient Care ◽

Behavioral Health ◽

Clinical Care ◽

Psychiatric Hospitals ◽

Behavioral Health Care ◽

Special Care ◽

Direct Patient Care ◽

Special Care Unit ◽

Psychiatric Facilities

Approximately 53,000 patients/year are admitted to psychiatric hospitals in Michigan and treatment typically involves social gatherings and group therapies (SAMHSA 2017; Michigan DHS 2019). Often psychiatric inpatients are in close proximity placing them at high risk of infection and have comorbid medical conditions that predispose them to severe COVID-19 consequences. In March 2020, Pine Rest Christian Mental Health Services, Grand Rapids, MI initiated protocols and precautions to mitigate the spread of COVID-19 between patients and health care personnel (HCP) based on emerging CDC guidelines. Multiple strategies [COVID-19 testing, masking of patients and HCP, restricting visitors, and creation of Special Care Unit (SCU) with negative pressure] were effectively implemented and limited transmission of COVID-19 within Pine Rest. Admission to the SCU totaled 25 adults (three Pine Rest patients who tested positive during or after admission, and 22 COVID-19 positive patients who were transferred from other facilities). Average age of SCU inpatients was 38.5 ± 16.6 years with the majority being male. Average hospitalization was 9 ± 4 days. Among the 21 COVID-19 positive HCP, 15 [71%] provided direct clinical care on various units, zero provided care on the SCU, and six had roles with no direct patient care. Average age among COVID-19 positive HCP providing direct patient care[n = 15] was 29.5 ± 13.5 years, majority were female, and 3 [20%] were admitted to local medical hospital for treatment. This report demonstrates that quality behavioral health care can be safely provided at inpatient psychiatric facilities and serve as a guideline that other psychiatric facilities can follow to decrease transmission in future epidemics.

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