scholarly journals Consolidated Person Level Health Data Improve Tuberculosis Surveillance and Patient Care

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Mariette Smith ◽  
Alexa Heekes ◽  
Arne Von Delft ◽  
Themba Mutemaringa ◽  
Nicki Tiffin ◽  
...  
Keyword(s):  
South Africa ◽  
Patient Care ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Digital Health ◽  
Care Facility ◽  
Improve Patient Care ◽  
Health Data ◽  
Register Data ◽  
Western Cape

IntroductionElectronic tuberculosis (TB) register systems influence policy decisions, resource allocation and patient care in many ways, but their limitations have been demonstrated in many high-burden settings like South Africa. While digital health systems in the Western Cape, South Africa have improved over time and benefited from implementation of a unique patient identifier, questions about quality and completeness of register data remain. A Health Information Exchange (HIE), established in 2015, daily integrates routinely-collected person level health data from electronic sources in the Province, including laboratory, dispensing, clinical and encounter data, as well as disease register data for HIV and TB. Objectives and ApproachUsing TB-related datapoints from various electronic platforms and resources, an algorithm was developed to infer cases, visit and treatment information, comorbidities and mortality - defined as a “cascade”. The cascade is recompiled daily incorporating new information added to the HIE, and presented to health care workers and managers as filterable, downloadable reports on an electronic platform. TB Register and inferred cascade data were compared for 2018. ResultsThere were 40,227 cases in the register after 3,010 duplicate entries were eliminated by consolidating personal identifiers and duplicate entries across facilities into single TB episodes. 13,729 additional cases were identified in the HIE cascade. Of these, 6,984 had evidence of treatment; 4,143 were diagnosed and treated only in hospitals - thus less likely to be recorded in the registers. Updated patient contact details and allocation of a primary care facility based on patient visit history, aided in patient care. Conclusion / ImplicationsLeveraging a consolidated environment for person-level health data can substantially enhance and verify disease registers. Appropriate tools can render these data accessible and actionable to improve patient care, minimise errors and missed opportunities to close treatment gaps, and increase accuracy of surveillance and reporting on a programmatic level.

scholarly journals South African experience consolidating person-level health data for both service and research in a single environment

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Andrew Boulle ◽  
Alexa Heekes ◽  
Themba Mutemaringa ◽  
Mariette Smit ◽  
Rosemary Foster ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Data Linkage ◽  
Health Information Exchange ◽  
Digital Health ◽  
Health Data ◽  
Data Availability ◽  
Functional Health ◽  
Data Centre ◽  
Single Well

IntroductionThere are few examples of functional health information exchange environments or data linkage centres in the African settings. New opportunities are emerging as unique health identifiers and patient registration systems are being established nationally in many countries, and increasingly individuated health data are available for linkage, often linked to priority global health initiatives such as to support HIV and tuberculosis services. Objectives and ApproachWe sought to establish a province-wide health information exchange and data centre for individuated health data, leveraging a unique identifier and available individuated data. The intention with the Provincial Health Data Centre (PHDC) was to create a single well-governed environment which could simultaneous fulfil the functions of an exchange directly supporting care, as well as support research requests. Often the demands of academics, funders and global agencies for reporting result in data consolidation for research and reporting taking precedence over service delivery. ResultsThrough pragmatic use of data from all sources, the PHDC is able to usefully enumerate many health conditions of interest with sufficient fidelity for both service and research purposes. For research data requests, there has been a huge improvement in data governance alongside increased data availability as a result of the single environment with clear procedures for patient protection, and the benefits of data linkage prior to anonymisation. Many of the inference approaches have benefited hugely from interactions with researchers, which has in turn improved the quality of outputs for routine care. Conclusion / ImplicationsIn maturing digital health environments which are establishing consolidated data environments for the first time, aspiring from the start to a single well-governed environment for both patient care and research, is a virtuous model with many benefits over fragmented data linkage efforts

scholarly journals Maturity assessment of Kenya’s health information system interoperability readiness

2021 ◽  
Vol 28 (1) ◽  
pp. e100241
Author(s):  
Job Nyangena ◽  
Rohini Rajgopal ◽  
Elizabeth Adhiambo Ombech ◽  
Enock Oloo ◽  
Humphrey Luchetu ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Working Group ◽  
Data Exchange ◽  
Enterprise Architecture ◽  
Health Information Exchange ◽  
Digital Health ◽  
Health Information System ◽  
Maturity Level ◽  
Technical Standards

BackgroundThe use of digital technology in healthcare promises to improve quality of care and reduce costs over time. This promise will be difficult to attain without interoperability: facilitating seamless health information exchange between the deployed digital health information systems (HIS).ObjectiveTo determine the maturity readiness of the interoperability capacity of Kenya’s HIS.MethodsWe used the HIS Interoperability Maturity Toolkit, developed by MEASURE Evaluation and the Health Data Collaborative’s Digital Health and Interoperability Working Group. The assessment was undertaken by eHealth stakeholder representatives primarily from the Ministry of Health’s Digital Health Technical Working Group. The toolkit focused on three major domains: leadership and governance, human resources and technology.ResultsMost domains are at the lowest two levels of maturity: nascent or emerging. At the nascent level, HIS activities happen by chance or represent isolated, ad hoc efforts. An emerging maturity level characterises a system with defined HIS processes and structures. However, such processes are not systematically documented and lack ongoing monitoring mechanisms.ConclusionNone of the domains had a maturity level greater than level 2 (emerging). The subdomains of governance structures for HIS, defined national enterprise architecture for HIS, defined technical standards for data exchange, nationwide communication network infrastructure, and capacity for operations and maintenance of hardware attained higher maturity levels. These findings are similar to those from interoperability maturity assessments done in Ghana and Uganda.

Regional and Community Health Information Exchange in the United States

2011 ◽  
pp. 198-218 ◽  
Author(s):  
Adi V. Gundlapalli ◽  
Jonathan H. Reid ◽  
Jan Root ◽  
Wu Xu
Keyword(s):  
United States ◽  
Patient Care ◽  
Community Health ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Business Case ◽  
The United States ◽  
Healthcare Systems ◽  
Secure Information

A fundamental premise of continuity in patient care and safety suggests timely sharing of health information among different providers at the point of care and after the visit. In most healthcare systems, this is achieved through exchange of written medical information, phone calls and conversations. In an ideal world, this exchange of health information between disparate providers, healthcare systems, laboratories, pharmacies and payers would be achieved electronically and seamlessly. The potential benefits of electronic health exchange are improved patient care, increased efficiency of the healthcare system and decreased costs. The reality is that health information is electronically exchanged only to a limited extent within local communities and regions, much less nationally and internationally. One main challenge has been the inability of health information exchange organizations to develop a solid business case. Other challenges have been socio-political in that data ownership and stewardship have not been clearly resolved. Technological improvements over the past 20 years have provided significant advances towards safe and secure information exchange. This chapter provides a general overview of community health information exchange in the United States of America, its history and details of challenges faced by stakeholders. The lessons learned from successes and failures, research and knowledge gaps and future prospects are also discussed. Current and future technologies to facilitate and invigorate health information exchange are highlighted. Two examples of successful regional health information exchanges in the US states of Utah and Indiana are highlighted.

scholarly journals Self-enrolment antenatal health promotion data as an adjunct to maternal clinical information systems in the Western Cape Province of South Africa

2018 ◽  
Vol 3 (Suppl 2) ◽  
pp. e000565 ◽  
Author(s):  
Alexa Heekes ◽  
Nicki Tiffin ◽  
Pierre Dane ◽  
Themba Mutemaringa ◽  
Mariette Smith ◽  
...  
Keyword(s):  
South Africa ◽  
Health Promotion ◽  
Information Systems ◽  
Pregnant Women ◽  
Information Exchange ◽  
Clinical Information ◽  
Clinical Information Systems ◽  
Western Cape ◽  
Public Health Services ◽  
Western Cape Province

Information systems designed to support health promotion in pregnancy, such as the MomConnect programme, are potential sources of clinical information which can be used to identify pregnancies prospectively and early on. In this paper we demonstrate the feasibility and value of linking records collected through the MomConnect programme, to an emergent province-wide health information exchange in the Western Cape Province of South Africa, which already enumerates pregnancies from a range of other clinical data sources. MomConnect registrations were linked to pregnant women known to the public health services using the limited identifiers collected by MomConnect. Three-quarters of MomConnect registrations could be linked to existing pregnant women, decreasing over time as recording of the national identifier decreased. The MomConnect records were usually the first evidence of pregnancy in pregnancies which were subsequently confirmed by other sources. Those at lower risk of adverse pregnancy outcomes were more likely to register. In some cases, MomConnect was the only evidence of pregnancy for a patient. In addition, the MomConnect records provided gestational age information and new and more recently updated contact numbers to the existing contact registry. The pilot integration of the data in the Western Cape Province of South Africa demonstrates how a client-facing system can augment clinical information systems, especially in contexts where electronic medical records are not widely available.

hData - A Simple XML Framework for Health Data Exchange

2009 ◽  
Author(s):  
Gerald Beuchelt ◽  
Harry Sleeper ◽  
Andrew Gregorowicz ◽  
Robert Dingwell
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Data Exchange ◽  
Health Information Exchange ◽  
Health Data ◽  
Care Providers ◽  
Future Health ◽  
Data Interoperability ◽  
History Of ◽  
Electronic Health

Health data interoperability issues limit the expected benefits of Electronic Health Record (EHR) systems. Ideally, the medical history of a patient is recorded in a set of digital continuity of care documents which are securely available to the patient and their care providers on demand. The history of electronic health data standards includes multiple standards organizations, differing goals, and ongoing efforts to reconcile the various specifications. Existing standards define a format that is too complex for exchanging health data effectively. We propose hData, a simple XML-based framework to describe health information. hData addresses the complexities of the current HL7 Clinical Document Architecture (CDA). hData is an XML design that can be completely validated by modern XML editors and is explicitly designed for extensibility to address future health information exchange needs. hData applies established best practices for XML document architectures to the health domain, thereby facilitating interoperability, increasing software developer productivity, and thus reducing the cost for creating and maintaining EHR technologies.

scholarly journals Incident tuberculosis disease in patients receiving biologic therapies in the Western Cape, South Africa from 2007 to 2018

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tessa du Toit ◽  
Tonya M. Esterhuizen ◽  
Nicki Tiffin ◽  
Ahmed A. Abulfathi ◽  
Helmuth Reuter ◽  
...  
Keyword(s):  
South Africa ◽  
Incidence Rate ◽  
Biologic Therapy ◽  
Health Data ◽  
Incidence Rates ◽  
Western Cape ◽  
Biologic Therapies ◽  
Increased Risk ◽  
Tnf Α ◽  
Tuberculosis Disease

Abstract Background South Africa has one of the highest tuberculosis incidence rates. Biologic disease-modifying anti-rheumatic drugs are associated with an increased risk of tuberculosis. The objective of this study was to describe the tuberculosis disease incidence rate among public sector patients receiving biologic therapies in the Western Cape Province. Methods A retrospective, descriptive analysis was undertaken using routine health data collated by the Provincial Health Data Centre from January 2007 (first use of biologic therapy in the Western Cape) to September 2018. Results We identified 609 patients treated with tumour necrosis factor-alpha (TNF-α) or non-TNF-α biologic therapies. Thirty-seven (37) patients developed tuberculosis after biologic therapy exposure, of whom the majority (78%) had an immune mediated inflammatory disease and the remainder (22%) a haematologic malignancy. The incidence rate of tuberculosis per 100,000 person-years was 2227 overall [95% confidence interval (CI): 1591, 3037]. Patients treated with TNF-α inhibitors and non-TNF-α inhibitors had estimated incidence rates of 2819 [95% CI: 1669, 4480] and 1825 [95% CI: 1131, 2797], respectively (p = 0.10). Conclusion Patients exposed to both TNF-α and non-TNF-α biologic therapies may have a higher incidence of tuberculosis disease compared to the background risk of 681 cases per 100,000 per year in the Western Cape.

Regional and Community Health Information Exchange in the United States

2011 ◽  
pp. 1470-1490
Author(s):  
Adi V. Gundlapalli ◽  
Jonathan H. Reid ◽  
Jan Root ◽  
Wu Xu
Keyword(s):  
United States ◽  
Patient Care ◽  
Community Health ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Business Case ◽  
The United States ◽  
Healthcare Systems ◽  
Secure Information

A fundamental premise of continuity in patient care and safety suggests timely sharing of health information among different providers at the point of care and after the visit. In most healthcare systems, this is achieved through exchange of written medical information, phone calls and conversations. In an ideal world, this exchange of health information between disparate providers, healthcare systems, laboratories, pharmacies and payers would be achieved electronically and seamlessly. The potential benefits of electronic health exchange are improved patient care, increased efficiency of the healthcare system and decreased costs. The reality is that health information is electronically exchanged only to a limited extent within local communities and regions, much less nationally and internationally. One main challenge has been the inability of health information exchange organizations to develop a solid business case. Other challenges have been socio-political in that data ownership and stewardship have not been clearly resolved. Technological improvements over the past 20 years have provided significant advances towards safe and secure information exchange. This chapter provides a general overview of community health information exchange in the United States of America, its history and details of challenges faced by stakeholders. The lessons learned from successes and failures, research and knowledge gaps and future prospects are also discussed. Current and future technologies to facilitate and invigorate health information exchange are highlighted. Two examples of successful regional health information exchanges in the US states of Utah and Indiana are highlighted.

scholarly journals Identifying Barriers That Prevent the Usage of Health Information Exchange in Ohio

2020 ◽  
Vol 36 (4) ◽  
pp. 148-156
Author(s):  
Aaron J. Lengel ◽  
Elise M. L. Carpenter ◽  
Andrew G. Azzi ◽  
Kristen L. DiDonato
Keyword(s):  
Health Care ◽  
Community Pharmacy ◽  
Patient Care ◽  
Health Information ◽  
Health Care Providers ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Grocery Store ◽  
Clinical Services ◽  
Care Providers

Background: As clinical services expand in community pharmacies, access to patient information through a health information exchange (HIE) may be of increased benefit to patient care. Objectives: To identify perceptions and barriers to the use of HIE by high-performing clinical pharmacists within a grocery store chain and collect other health care provider perceptions of using HIE. Methods: Two web-based surveys consisting of multiple choice, select all that apply, and 5-point Likert-type scale questions were administered via email to Ohio pharmacists working in high clinical performing pharmacies and Ohio health care providers utilizing CliniSync, an Ohio-based HIE program. Outcomes measured included pharmacist perceptions of preparedness to participate in HIE, their relationship with patients and health care providers, and barriers to utilizing HIE. Provider outcomes included perceptions of relationships with patients, awareness of community pharmacy services, referral habits, and perceived benefit of a HIE. Results: Pharmacists tend to believe they have the skill (median 5, interquartile range [IQR] 1) and desire (median 5, IQR 1) to be a part of the HIE network. Pharmacists appear confident in their abilities to provide patient care as a part of HIE networks (median 4, IQR 1). While 66% of providers surveyed are aware of services provided by community pharmacists, 75% state that they do not refer patients to a pharmacy for those services. Conclusion: Implementing HIE into clinical pharmacy workflow and encouraging providers to use it to make patient health information available to pharmacists would provide additional information for pharmacists to review when providing clinical services in the community pharmacy setting, ultimately benefiting patient care.

Sign in / Sign up

Export Citation Format

Share Document