scholarly journals Information technology-based joint preoperative assessment, risk stratification and its impact on patient management, perioperative outcome, and cost

Discoveries ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. e130
Author(s):  
Habib Md Reazaul Karim ◽  
◽  
Subrata Kumar Singha ◽  
Praveen Kumar Neema ◽  
Tridip Dutta Baruah ◽  
...  
Keyword(s):  
Information Technology ◽  
Risk Stratification ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Preoperative Assessment ◽  
P Value ◽  
Routine Practice ◽  
Perioperative Outcome ◽  
Hospital Visit ◽  
Randomised Study

Background: Despite negative recommendations, routine preoperative testing practice is nearly universal. Our aim is to bring the healthcare providers on one platform by using information-technology based preanaesthetic assessment and evaluate the routine preoperative testing’s impact on patient outcome and cost. Methods: A prospective, non-randomised study was conducted in a teaching hospital during January 2019-August 2020. A locally developed software and cloud-computing were used as a tool to modify preanaesthesia evaluation. The number of investigations ordered, time taken, cost incurred, were compared with the routine practice. Further data were matched as per surgical invasiveness and the patient's physical status. Appropriate tests compared intergroup differences and p-value <0.05 was considered significant. Results: Data from 114 patients (58 in routine and 56 in patient and surgery specific) were analysed. Patient and surgery specific investigation led to a reduction in the investigations by 80-90%, hospital visit by 50%, and the total cost by 80%, without increasing the day of surgery cancellation or complications. Conclusion: Information technology-based joint preoperative assessment and risk stratification are feasible through locally developed software with minimal cost. It helps in applying patient and surgery specific investigation, reducing the number of tests, hospital visit, and cost, without adversely affecting the perioperative outcome. The application of the modified method will help in cost-effective, yet quality and safe perioperative healthcare delivery. It will also benefit the public from both service and economic perspective.

The Implementation and Future Directions of e-Health Information Policy

2011 ◽  
Vol 3 (3) ◽  
pp. 1-9 ◽  
Author(s):  
Evagelia C. Lappa ◽  
Georgios A. Giannakopoulos
Keyword(s):  
Information Technology ◽  
Health Information ◽  
Medical Records ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Medical Knowledge ◽  
Classification Systems ◽  
Medical Decision ◽  
Sensitive Information ◽  
Medical Decision Support Systems

Information technology has the potential to transform working procedure in the health care sector. Clinicians have used Health Information Management and Technology (HIM&T) for more than two decades to assist in achieving better healthcare delivery outcomes. Medical knowledge is too complex for humans to master in a single mind, and to remember everything about each patient. Medical data consist of many kinds of data from different sources, requiring the development of many medical decision support systems. Creating and indexing records for hospitals and health systems present difficult challenges, because the medical records contain sensitive information. Increased computerization and other policy factors have contributed to privacy risks. Transforming from paper-based to Electronic Medical Records (EMR) allows healthcare providers to share information across their care ecosystem. Access to this digital lifeline, connecting the EMR to the digital web platforma, is critical to saving lives, preventing medical errors and improving efficiency of healthcare delivery. Choosing the international classification systems for patients, ICD, DRGs, grouped patients according to the resources consumption required for treatment and other clinical characteristics. Information Technology provides solutions to this problem. A vital element of healthcare delivery is to ensure that the patient is always at the centre of everything clinicians do.

scholarly journals Influence of AIDET in the improving quality metrics in a small community hospital - before and after analysis

2015 ◽  
Vol 4 (3) ◽  
pp. 35 ◽  
Author(s):  
Raul Zamora ◽  
Mitun Patel ◽  
Bryan Doherty ◽  
Adam Alperstein ◽  
Peter Devito
Keyword(s):  
Care Delivery ◽  
Statistical Significance ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Core Competency ◽  
Communication Strategy ◽  
The Other ◽  
P Value ◽  
Small Community ◽  
Other Hand

Background: As the US healthcare system is becoming a more outcomes based system, increasing emphasis is being paidto improving all aspects of health care delivery. Interpersonal and communication skills, an ACGME (Accreditation Councilfor Graduate Medical Education) core competency in resident education, play a fundamental role in this effort. This aspectof healthcare delivery is also part of Medicare hospital reviews. In our hospital, the administration has introduced AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you) as a communication strategy which promises to improveexchange of information between healthcare professionals as well as with patients and their families. Objective: Determine if theAIDET strategy used in our facility has improved patient satisfaction.Methods: This study was done using pretest post test experimental design. Patient satisfaction was measured using scores fromthe HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) quarterly reports from the 3rd quarter of2010 to the 2nd quarter of 2013. Pre and post AIDET implementation results were statistically analysed using a paired t-test.Results are reported as a p-value with < .05 being statistically significant.Results: There were a total of 1,811 patient responses sampled from the 3rd quarter of 2010 to the 2nd quarter of 2013. Asignificant change < .05 was seen in the way Nurses Explain, Doctors Explain and Nurses listen in the pre and post AIDETimplementation comparison. The change in percentage of patients that believed doctors and nurses explained things to them in away they could understand showed a p-value of .02. The trend in percentage of patients that perceived that nurses always listenedcarefully to them showed a p-value of .02 as well. On the other hand, the data evaluating how doctors listened carefully to themdid not reach statistical significance with a p-value of .08. The remaining categories of “Told About Medication” and “Help afterDischarge” were both found not have changed significantly either.Conclusions: The implementation of AIDET education may have had a significant impact on provider-patient communication inour facility, especially in the patient’s perception of explaining things in a way they could understand. On the other hand, in theresponses to the question of whether or not doctors listened carefully to them, there was some improvement over time, howeverthis did not achieve statistical significance.

Knowledge and Communication of the National Core Standards Tool

2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Winnie Thembisile Maphumulo ◽  
Busisiwe Bhengu
Keyword(s):  
Pearson Correlation ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Sampling Technique ◽  
Quality Of Healthcare ◽  
Survey Study ◽  
Public Healthcare ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Professional Nurses

The National Department of Health in South Africa has introduced the National Core Standards (NCS) tool to improve the quality of healthcare delivery in all public healthcare institutions. Knowledge of the NCS tool is essential among healthcare providers. This study investigated the level of knowledge on NCS and how the NCS tool was communicated among professional nurses. This was a cross-sectional survey study. Purposive sampling technique was used to select hospitals that only offered tertiary services in KwaZulu-Natal. Six strata of departments were selected using simple stratified sampling. The population of professional nurses in the selected hospitals was 3 050. Systematic random sampling was used to recruit 543 participants. The collected data were analysed using SPSS version 25. The study showed that only 16 (3.7%) respondents had knowledge about NCS, using McDonald’s standard of learning outcome measured criteria regarding the NCS tool. The Pearson correlation coefficient between the communication and knowledge was r = 0.055. The results revealed that although the communication scores for the respondents were high their knowledge scores remained low. This study concluded that there is a lack of knowledge regarding the NCS tool and therefore healthcare institutions need to commit themselves to the training of professional nurses regarding the NCS tool. The findings suggest that healthcare institutions implement the allocation of incentives for nurses that attend the workshops for NCS.

e-Learning: Practices Among Undergraduates of a Medical College of Khyber Pakhtunkhwa

2020 ◽  
Keyword(s):  
Information Technology ◽  
Medical Students ◽  
Background Information ◽  
P Value ◽  
Undergraduate Medical Students ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical College ◽  
Learning Practices ◽  
E Learning

Background: Information technology (IT) is a new way of teaching and learning. One of the promising media of information technology is e-Learning, which is used to enhance knowledge and skills among users. A student gains better and deep knowledge through a useful tool. This survey aimed to determine practices among medical students for e-Learning. Methods: This cross-sectional survey was conducted on 184 students amongst the 500 students currently enrolled in medical college. Data was collected using questionnaires and were analyzed through SPSS version 22. Chi-square was used for qualitative values. Results: Majority 90.80% (n=167) students were aware of e-Learning and were statistically high in first year students (p-value: 0.018). The student did not show statistically significant results for content learned through e-Learning with a p-value of 0.063. Different resources were used for e-Learning in which videos had the highest percentage (87.60%) and audios were used as the least resource for e-Learning (29.20%). Daily, 56% of the students use e-Learning for 1 hour or less and only 3% of the students used it for more than 4 hours. Conclusion: Majority of undergraduate medical students were aware of the use of e-Learning and most of them preferred e-Learning for their course work and studies showing a significant increase in understanding and use, compared to studies conducted earlier. Participants found e-Learning useful and effective tool in increasing knowledge and understanding of their subject. Keywords: e-Learning; Practices; Students.

scholarly journals Risk stratification scores for hospitalization duration and disease progression in moderate and severe patients with COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiaqi Huang ◽  
Yu Xu ◽  
Bin Wang ◽  
Ying Xiang ◽  
Na Wu ◽  
...  
Keyword(s):  
Platelet Count ◽  
Lactate Dehydrogenase ◽  
Risk Stratification ◽  
Disease Progression ◽  
Risk Score ◽  
Healthcare Providers ◽  
Maximum Body ◽  
Score Systems ◽  
Risk Categories ◽  
Risk Stratification Score

Abstract Background During outbreak of Coronavirus Disease 2019 (COVID-19), healthcare providers are facing critical clinical decisions based on the prognosis of patients. Decision support tools of risk stratification are needed to predict outcomes in patients with different clinical types of COVID-19. Methods This retrospective cohort study recruited 2425 patients with moderate or severe COVID-19. A logistic regression model was used to select and estimate the factors independently associated with outcomes. Simplified risk stratification score systems were constructed to predict outcomes in moderate and severe patients with COVID-19, and their performances were evaluated by discrimination and calibration. Results We constructed two risk stratification score systems, named as STPCAL (including significant factors in the prediction model: number of clinical symptoms, the maximum body temperature during hospitalization, platelet count, C-reactive protein, albumin and lactate dehydrogenase) and TRPNCLP (including maximum body temperature during hospitalization, history of respiratory diseases, platelet count, neutrophil-to-lymphocyte ratio, creatinine, lactate dehydrogenase, and prothrombin time), to predict hospitalization duration for moderate patients and disease progression for severe patients, respectively. According to STPCAL score, moderate patients were classified into three risk categories for a longer hospital duration: low (Score 0–1, median = 8 days, with less than 20.0% probabilities), intermediate (Score 2–6, median = 13 days, with 30.0–78.9% probabilities), high (Score 7–9, median = 19 days, with more than 86.5% probabilities). Severe patients were stratified into three risk categories for disease progression: low risk (Score 0–5, with less than 12.7% probabilities), intermediate risk (Score 6–11, with 18.6–69.1% probabilities), and high risk (Score 12–16, with more than 77.9% probabilities) by TRPNCLP score. The two risk scores performed well with good discrimination and calibration. Conclusions Two easy-to-use risk stratification score systems were built to predict the outcomes in COVID-19 patients with different clinical types. Identifying high risk patients with longer stay or poor prognosis could assist healthcare providers in triaging patients when allocating limited healthcare during COVID-19 outbreak.

scholarly journals A survey of the knowledge and attitudes of Egyptian healthcare professionals towards the application of Health Information Technology to optimize antibiotic therapy

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i28-i28
Author(s):  
N Hassan ◽  
R Slight ◽  
S P Slight
Keyword(s):  
Information Technology ◽  
Developing Countries ◽  
Antimicrobial Resistance ◽  
Health Information Technology ◽  
Health Information ◽  
Antimicrobial Stewardship ◽  
Healthcare Professionals ◽  
Response Rate ◽  
Public Healthcare ◽  
P Value

Abstract Introduction Antimicrobial resistance is a global health problem, especially in developing countries. Antimicrobial Stewardship Programmes (AMS) have been shown to be effective at reducing antimicrobial resistance and hospital patient stays. Health information technology (HIT) can support Outpatient Parenteral Antimicrobial Therapy (OPAT) through more accurate diagnosis and management of infectious diseases. Aim To evaluate the knowledge and attitude of Egyptian healthcare professionals towards the application of HIT to optimize OPAT. Methods Healthcare professionals who worked in either private or public sectors of Egyptian healthcare system were emailed and asked if they would be willing to complete an electronic questionnaire (using google forms). One reminder was sent by email each week for two weeks (two in total) from the first invitation. The survey was laid out in four sections. The first section included specific details about the healthcare professional’s current employment and role, the second related to HIT services available in their organisations, the third covered their training in HIT and antimicrobial stewardship programmes, and the fourth included their use of HIT to optimize OPAT. Ethical approval was obtained from National Heart Institute, Egypt. Descriptive analysis was carried out for all the variables. One-way ANOVA testing at level of significance P-value &lt;0.05, was used to compare numerical variables. SPSS version 26 was used for statistical analysis. Results Three hundred and eighty-five healthcare professionals were invited to respond to the questionnaire. (The response rate was 75.34% (290)). Of these, 152 (52.6%) were pharmacists, 134 (46.4%) physicians, and 3 (1%) nurses, and many participants (30.8%) had between 6 to 10 years of experience working in either outpatient or in-patient units. Only 15.2% of respondents mentioned that they have access to OPAT in their organizations, 51.2% did not have the service, while 33.6% responded that they did not know if the service was available. However, 27.3% had a training on ASP and 18.3% had a training on HIT. Mean scores for both knowledge (14.31±5.49) and attitude (14.67±2.53) were significantly higher in professionals who had received training in HIT (p = 0.003 & 0.006 respectively). However, scores for attitude were better than scores for knowledge. Conclusions In developing countries, HIT applications in OPAT are still in their infancy with only a few organisations adopting them. Egyptian healthcare professionals showed positive attitudes towards HIT use, especially when their knowledge was improved through training. Two strengths of this study include our high response rate and the wide breadth of different healthcare professionals who responded from both private and public healthcare settings. However, being a questionnaire, some questions were left unanswered and some respondents may not have been aware of their reasons for a particular answer. That said, this study has important implications for practice, with more awareness amongst healthcare professionals required on the availability of HIT services in their hospitals and how further training may be needed on the applications of HIT in optimizing OPAT.

How Research Will Adapt to HIPAA: A View from Within the Healthcare Delivery System

2002 ◽  
Vol 28 (4) ◽  
pp. 491-502
Author(s):  
Mary L. Durham
Keyword(s):  
Health Information ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
The United States ◽  
Personal Health Information ◽  
Personal Health ◽  
Business Associations ◽  
Electronic Information ◽  
Healthcare Delivery System ◽  
Institutional Review

While the new Health Insurance Privacy and Accountability Act (HIPAA) research rules governing privacy, confidentiality and personal health information will challenge the research and medical communities, history teaches us that the difficulty of this challenge pales in comparison to the potential harms that such regulations are designed to avoid. Although revised following broad commentary from researchers and healthcare providers around the country, the HIPAA privacy requirements will dramatically change the way healthcare researchers do their jobs in the United States. Given our reluctance to change, we risk overlooking potentially valid reasons why access to personal health information is restricted and regulated. In an environment of electronic information, public concern, genetic information and decline of public trust, regulations are ever-changing. Six categories of HIPAA requirements stand out as transformative: disclosure accounting/tracking, business associations, institutional review board (IRB) changes, minimum necessary requirements, data de-identification, and criminal and civil penalties.

scholarly journals A Serum Metabolomics Classifier Derived from Elderly Patients with Metastatic Colorectal Cancer Predicts Relapse in the Adjuvant Setting

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2762
Author(s):  
Samantha Di Donato ◽  
Alessia Vignoli ◽  
Chiara Biagioni ◽  
Luca Malorni ◽  
Elena Mori ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Stratification ◽  
Elderly Patients ◽  
Metastatic Colorectal Cancer ◽  
Early Stage ◽  
Prospective Trial ◽  
Proton Nuclear Magnetic Resonance ◽  
P Value ◽  
Resonance Spectroscopy ◽  
Metabolomic Fingerprinting

Adjuvant treatment for patients with early stage colorectal cancer (eCRC) is currently based on suboptimal risk stratification, especially for elderly patients. Metabolomics may improve the identification of patients with residual micrometastases after surgery. In this retrospective study, we hypothesized that metabolomic fingerprinting could improve risk stratification in patients with eCRC. Serum samples obtained after surgery from 94 elderly patients with eCRC (65 relapse free and 29 relapsed, after 5-years median follow up), and from 75 elderly patients with metastatic colorectal cancer (mCRC) obtained before a new line of chemotherapy, were retrospectively analyzed via proton nuclear magnetic resonance spectroscopy. The prognostic role of metabolomics in patients with eCRC was assessed using Kaplan–Meier curves. PCA-CA-kNN could discriminate the metabolomic fingerprint of patients with relapse-free eCRC and mCRC (70.0% accuracy using NOESY spectra). This model was used to classify the samples of patients with relapsed eCRC: 69% of eCRC patients with relapse were predicted as metastatic. The metabolomic classification was strongly associated with prognosis (p-value 0.0005, HR 3.64), independently of tumor stage. In conclusion, metabolomics could be an innovative tool to refine risk stratification in elderly patients with eCRC. Based on these results, a prospective trial aimed at improving risk stratification by metabolomic fingerprinting (LIBIMET) is ongoing.

Implications for the Physical Design of the Postnatal Care Unit from a Targeted Analysis of Issues With Accessing the Bathroom at Night in the Acute Setting: A Secondary Analysis

2021 ◽  
Vol 10 (1) ◽  
pp. 309-312
Author(s):  
Varshita Chirumamilla ◽  
Joseph M. Gerard ◽  
Alison E. Sweeney ◽  
Kristin P. Tully ◽  
Alison M. Stuebe ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Secondary Analysis ◽  
Hospital Environment ◽  
Patient Room ◽  
Hospital Visit ◽  
Acute Setting ◽  
Targeted Analysis ◽  
Standard Patient ◽  
Clinical Environments ◽  
Visual Privacy

Assessing hospital environment conditions is necessary for healthcare providers and patients to coordinate safe care. The aims of this research included: a) identifying patterns in hospital visit feedback transcripts regarding bathroom doors and lights in the hospital room and b) interpreting the results to make recommendations for more enabling clinical environments. The methods used by the research team included organizing transcript data, assigning codes, and conducting an interrater reliability test to assess codebook efficacy. Finally, working with maternal and infant mortality experts, recommendations for the hospital were developed. We identified four possible interventions to address barriers: a) implement low-height, dimmable lighting along the base of the patient room, b) provide personal lights, such as penlights, to staff for nighttime assessments, c) install and improve on existing grab bars in patient room bathrooms and d) replace the standard patient room bathroom door with a different kind of auditory/visual privacy barrier.

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