Use of LOINC and SNOMED CT with FHIR for Microbiology Data

Infectious diseases due to microbial resistance pose a worldwide threat that calls for data sharing and the rapid reuse of medical data from health care to research. The integration of pathogen-related data from different hospitals can yield intelligent infection control systems that detect potentially dangerous germs as early as possible. Within the use case Infection Control of the German HiGHmed Project, eight university hospitals have agreed to share their data to enable analysis of various data sources. Data sharing among different hospitals requires interoperability standards that define the structure and the terminology of the information to be exchanged. This article presents the work performed at the University Hospital Charité and Berlin Institute of Health towards a standard model to exchange microbiology data. Fast Healthcare Interoperability Resources (FHIR) is a standard for fast information exchange that allows to model healthcare information, based on information packets called resources, which can be customized into so-called profiles to match use case- specific needs. We show how we created the specific profiles for microbiology data. The model was implemented using FHIR for the structure definition, and the international standards SNOMED CT and LOINC for the terminology services.

Download Full-text

From OpenEHR to FHIR and OMOP Data Model for Microbiology Findings

Studies in Health Technology and Informatics - Public Health and Informatics ◽

10.3233/shti210189 ◽

2021 ◽

Author(s):

Eugenia Rinaldi ◽

Sylvia Thun

Keyword(s):

Infection Control ◽

Data Model ◽

Data Exchange ◽

Control Group ◽

Common Data Model ◽

University Hospitals ◽

Data Set ◽

Related Data ◽

National Initiative ◽

Data Elements

HiGHmed is a German Consortium where eight University Hospitals have agreed to the cross-institutional data exchange through novel medical informatics solutions. The HiGHmed Use Case Infection Control group has modelled a set of infection-related data in the openEHR format. In order to establish interoperability with the other German Consortia belonging to the same national initiative, we mapped the openEHR information to the Fast Healthcare Interoperability Resources (FHIR) format recommended within the initiative. FHIR enables fast exchange of data thanks to the discrete and independent data elements into which information is organized. Furthermore, to explore the possibility of maximizing analysis capabilities for our data set, we subsequently mapped the FHIR elements to the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM). The OMOP data model is designed to support the conduct of research to identify and evaluate associations between interventions and outcomes caused by these interventions. Mapping across standard allows to exploit their peculiarities while establishing and/or maintaining interoperability. This article provides an overview of our experience in mapping infection control related data across three different standards openEHR, FHIR and OMOP CDM.

Download Full-text

SYNTHESIS OF THE ORGANIZATION OF TREATMENT, RESEARCH AND TEACHING (CASE STUDY AT THE UNIVERSITY HOSPITAL IN AACHEN)

Current problems of architecture and urban planning ◽

10.32347/2077-3455.2021.61.349-358 ◽

2021 ◽

pp. 349-358

Author(s):

Maryna Lienkova ◽

Irina Bulakh

Keyword(s):

Medical Center ◽

Multidisciplinary Treatment ◽

University Hospital ◽

Survey Analysis ◽

University Hospitals ◽

Medical Institutions ◽

Hospital Patients ◽

Student Training ◽

Treatment Research ◽

The University

The article considers and analyzes the existing in the world, but new for Ukraine, type of healthcare institutions - a university hospital, which today is an example of one of the largest and best university hospitals in Germany - the Medical Center of the University of Aachen. The planning and functional structure of the university hospital and special design approaches that contributed to its design and development are analyzed. The purpose of the article is to illustrate an innovative approach for our state to the organization of medical institutions and to emphasize the importance of their implementation in the domestic healthcare system. The research methodology is based on the systematization and analysis of data from various information sources, as well as on the method of sociological survey (analysis of reviews). The article considers the features of the structure of the University Hospital Aachen, namely the multidisciplinary treatment, research and student training, which are combined in one institution. According to hospital patients, the only drawback of this structure is the frequent long wait for visitors. This is probably due to the significant daily flow of patients of varying complexity and, consequently, the shortcomings of the managerial approach. However, at the same time, the hospital has many advantages, which were highlighted in the article.

Download Full-text

An Audit of Wait Times for Service Offered by the Gynaecology Oncology Unit at the University Hospital in Jamaica: Are We Meeting the Standards?

Journal of Global Oncology ◽

10.1200/jgo.2016.004564 ◽

2016 ◽

Vol 2 (3_suppl) ◽

pp. 74s-74s

Author(s):

Ian Bambury ◽

Christopher Fletcher ◽

Carole Rattray ◽

Matthew Taylor ◽

Charmaine Mitchell ◽

...

Keyword(s):

Radiation Therapy ◽

Conflicts Of Interest ◽

Waiting Times ◽

Wait Time ◽

International Standards ◽

University Hospital ◽

Wait Times ◽

Oncology Unit ◽

The University ◽

Mean Time

Abstract 53 Background: The European Board and College of Obstetrics and Gynaecology recommends that time from referral of suspected or proven gynaecological cancers to consultation should be within two weeks and that initiation of treatment should occur within six weeks. It is has been shown that a delay in waiting times beyond these international standards results in significantly increased morbidity and mortality. Methods: An audit of wait times was performed for all patients who presented to the gynaecology oncology unit at the University Hospital in Jamaica for consultation between January 1, 2013 and December 31, 2013. Wait time for consultation was calculated as the date of first referral to the date of initial consultation. Wait time for treatment was calculated as time from consultation to either surgery or initiation of radiation therapy or chemotherapy. Primary site, stage, and the region from which the referrals came were abstracted from the medical record. Results: A total of 1,289 unique patients were seen at least once during the audit period; of these, 108 were new consultations and 1,219 were patients seen for follow-up. 72% were from the greater metropolitan area (Kingston & St. Andrew), while the others were from the surrounding parishes of Jamaica. Of the 108 new patients, malignancy was confirmed in 70 (65%). Case make-up included 23 cases of endometrial cancer (33%); 20 cases of cervical cancer (29%); 16 cases of ovarian cancer (23%); and 11 cases of other gynecologic cancers (vulvar, vaginal, choriocarcinoma) (15%). At presentation, there were 23 patients with stage 1 disease (33%), 16 patients with stage 2 disease (23%), 27 patients with stage 3 disease (38%); and 4 patients with stage 4 disease (6%). 39 out of 70 patients with malignancy (56%) underwent surgery; 11 (15.7%) were treated with radiation therapy; and 22 (31%) were treated with chemotherapy. Among patients with a cancer diagnosis, the mean time from referral to consultation was 2.1 weeks. Mean time from consultation to surgery was 7.6 weeks; mean time from consultation to start of radiotherapy was 16 weeks; and mean time from consultation to start of chemotherapy was 11.6 weeks. 66% of patients underwent surgery within the international standard of six weeks from referral. Only 36% initiated radiation therapy and 14% initiated chemotherapy within six weeks from referral. Conclusion: While the majority of patients met international standards for time to consultation to surgery, wait times for initiation of radiation and chemotherapy were sub-standard. This audit has provided information that will help us to assess the inadequacy of available services and could potentially inform national cancer policies in Jamaica. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

Download Full-text

Healthcare Epidemiology Practicum Rotation for Postgraduate Physician Trainees in Medicine–Infectious Diseases

Infection Control and Hospital Epidemiology ◽

10.1086/673150 ◽

2013 ◽

Vol 34 (10) ◽

pp. 1114-1116

Author(s):

Pranavi Sreeramoju ◽

Maria Eva Fernandez-Rojas

Keyword(s):

Infectious Diseases ◽

Infection Control ◽

Medical Center ◽

Common Trunk ◽

University Hospitals ◽

Hospital System ◽

University Of Texas ◽

Core Rotation ◽

The University ◽

Healthcare Epidemiology

Practicum education in healthcare epidemiology and infection control (HEIC) for postgraduate physician trainees in infectious diseases is necessary to prepare them to be future participants and leaders in patient safety. Voss et al suggested that training in HEIC should be offered as a “common trunk” for physicians being trained in clinical microbiology or infectious diseases. A 1-month rotation has been recommended previously. A survey by Joiner et al indicated that only 50% of infectious diseases fellows found the infection control training adequate. The objective of this article is to report our 2-year experience with a 1-month practicum rotation we designed and implemented at our institution.The setting is the Adult Infectious Diseases fellowship program at the University of Texas Southwestern Medical Center (UTSW), Dallas, Texas. The fellows have clinical rotations at the Parkland Health and Hospital System, UTSW University hospitals, North Texas Veterans Affairs Health Care System, and Children's Medical Center Dallas. The 2-year program recruits 7 fellows every 2 years. The 1-month core rotation was established in July 2011 and is ongoing. Fellows who completed the rotation during the period July 2011 to April 2013 are included in this study.

Download Full-text

Nasal Carriage Rate and Antimicrobial Resistance Profiles of MethicillinResistant Staphylococcus Aureus (MRSA) among Health Care Workers in Tanta University Hospital

10.51429/ejmm29401 ◽

2020 ◽

Vol EJMM29 (4) ◽

pp. 1-7

Author(s):

Marwa S. Taha ◽

Eman A. Younis ◽

Eman E. Hegazy

Keyword(s):

Infection Control ◽

Nasal Carriage ◽

University Hospital ◽

Resistant Organism ◽

University Hospitals ◽

Carriage Rate ◽

Mannitol Salt Agar ◽

Vulnerable Patients ◽

Nasal Swabs ◽

History Of

Background: MRSA is the most commonly known antimicrobial-resistant organism in hospitals worldwide. Objectives: This study aimed to detect the prevalence of MRSA carriage and its antibiogram among HCWs in Tanta University hospitals to improve infection control and preventive measures. Methodology: 223 nasal swabs from HCWs were inoculated onto Mannitol salt agar. Detection of MRSA was performed phenotypically using cefoxitin disc diffusion test on Muller–Hinton agar plates. Confirmation of MRSA was done by determining minimum inhibitory concentration (MIC) of oxacillin by using E Test Strips. Results: Amongst the HCWs, 88 doctors and 135 nurses were randomly selected. The overall frequency of S. aureus nasal carriage was 129/223. Of the 129 S. aureus isolates, (17%) were MRSA. Internal medicine had a high proportion of MRSA positive (36.4%). (63.6%) of the MRSA positive HCWs had a history of using antibiotics during the past 3 months. A high frequency (77.3%) of MRSA was detected among nurses. (50%) HCWs with 5:10 years of working experience were colonized with MRSA. Conclusion: Multi-drug resistant organisms such as MRSA are a major public health challenge. Colonized HCWs are asymptomatic carriers and can transmit MRSA to vulnerable patients. To control the transmission of MRSA in hospitals, multidisciplinary efforts are recommended to implement and improve infection control policies.

Download Full-text

Albania vs Norway – FM at two university hospitals

Facilities ◽

10.1108/f-07-2016-0079 ◽

2017 ◽

Vol 35 (7/8) ◽

pp. 462-484

Author(s):

Knut Boge ◽

Anjola Aliaj

Keyword(s):

Strong Support ◽

University Hospital ◽

Comparative Case Study ◽

Facilities Management ◽

University Hospitals ◽

Content Type ◽

Adequate Food ◽

The University ◽

House Production

PurposeGiven the premise of de facto universal standards for FM, this paper aims to investigate development of facilities management (FM) at an Albanian and a Norwegian university hospital through examination of two hypotheses: the university hospital has recognised FM and established a designated FM organisation (H1) and the university hospital provides adequate food and catering services at ward kitchens and buffets (H2). Design/methodology/approachThis is an exploratory and descriptive comparative case study based on a diverse cases’ designs. FindingsThere is limited and strong support for H1 at the Albanian and Norwegian university hospitals, respectively. Both the Albanian and the Norwegian university hospitals rely on in-house production of facilities services, but the Albanian university hospital has outsourced food and catering services. FM and provision of facilities services are deeply integrated within the Norwegian university hospital’s core activities. There is also limited and strong support for H2 at the Albanian and Norwegian university hospitals, respectively. Hence, the Albanian Ministry of Health and the Albanian university hospital’s top management have a comprehensive, but not impossible, task, if the aim is to catch up with the Norwegian university hospital concerning FM. Research limitations/implicationsThis is an exploratory and descriptive comparative case study. Large N studies should be carried out both in Albania and Norway and preferably also in other countries to corroborate and develop the findings. Originality/valueThis is the first comparative study of FM at an Albanian and a Norwegian university hospital.

Download Full-text

Reduced Rate of Inpatient Hospital Admissions in 18 German University Hospitals During the COVID-19 Lockdown

Frontiers in Public Health ◽

10.3389/fpubh.2020.594117 ◽

2021 ◽

Vol 8 ◽

Author(s):

Lorenz A. Kapsner ◽

Marvin O. Kampf ◽

Susanne A. Seuchter ◽

Julian Gruendner ◽

Christian Gulden ◽

...

Keyword(s):

Critical Care ◽

Hospital Admissions ◽

Study Data ◽

University Hospital ◽

Care Process ◽

Benign Tumors ◽

University Hospitals ◽

Inpatient Hospital ◽

Admission Rates ◽

The University

The COVID-19 pandemic has caused strains on health systems worldwide disrupting routine hospital services for all non-COVID patients. Within this retrospective study, we analyzed inpatient hospital admissions across 18 German university hospitals during the 2020 lockdown period compared to 2018. Patients admitted to hospital between January 1 and May 31, 2020 and the corresponding periods in 2018 and 2019 were included in this study. Data derived from electronic health records were collected and analyzed using the data integration center infrastructure implemented in the university hospitals that are part of the four consortia funded by the German Medical Informatics Initiative. Admissions were grouped and counted by ICD 10 chapters and specific reasons for treatment at each site. Pooled aggregated data were centrally analyzed with descriptive statistics to compare absolute and relative differences between time periods of different years. The results illustrate how care process adoptions depended on the COVID-19 epidemiological situation and the criticality of the disease. Overall inpatient hospital admissions decreased by 35% in weeks 1 to 4 and by 30.3% in weeks 5 to 8 after the lockdown announcement compared to 2018. Even hospital admissions for critical care conditions such as malignant cancer treatments were reduced. We also noted a high reduction of emergency admissions such as myocardial infarction (38.7%), whereas the reduction in stroke admissions was smaller (19.6%). In contrast, we observed a considerable reduction in admissions for non-critical clinical situations, such as hysterectomies for benign tumors (78.8%) and hip replacements due to arthrosis (82.4%). In summary, our study shows that the university hospital admission rates in Germany were substantially reduced following the national COVID-19 lockdown. These included critical care or emergency conditions in which deferral is expected to impair clinical outcomes. Future studies are needed to delineate how appropriate medical care of critically ill patients can be maintained during a pandemic.

Download Full-text

Evaluation of the Tendencies of Urology Residents in Different Training Centers in Turkey on the Use of Fluoroscopy in Operations

10.22541/au.162444324.40160935/v1 ◽

2021 ◽

Author(s):

Samet Senel ◽

Fatih Sandikci ◽

Ali Yasin Ozercan ◽

Emin Gurtan ◽

Salih Zeki Sonmez ◽

...

Keyword(s):

Daily Practice ◽

University Hospital ◽

University Hospitals ◽

Study Results ◽

Significant Difference ◽

Training And Research ◽

Harmful Radiation ◽

And Behavior ◽

The University ◽

Harmful Effects

Aim: To evaluate the tendency, knowledge, awareness and behavior patterns of urology residents training at different institutions in Turkey about the use of fluoroscopy in operations. Methods: The 13-questioned survey prepared using “Google Forms©” as of 01.03.2021 was shared for four weeks in the “WhatsApp®” application group, which includes 279 urology residents studying with university hospitals and training and research hospitals in Turkey. One hundred and thirteen participants, who completed the questionnaire were included in the study. Results: Of the 113 urology residents included in the study, 56 (49.6%) were studying in university hospitals and 57 (50.4%) were in training and research hospitals. 67.3% of the residents stated that they never hesitated to participate in the operations which fluoroscopy was used. Additionally, the residents stated that, also 43.4% of the auxiliary healthcare staff frequently refrain from being involved in these cases(p <0.001). While 21 (37.5%) of the residents trained in the university hospital reported that they hesitated from these cases, this rate was found that 16 (28.2%) of the residents who were trained in the training and research hospitals and a significant difference was observed between two groups (p <0.016). Among residents, the rate of using radioprotective lead apron was 94.7%, and the rate of thyroid shield use was 98.2%. While the rate of using radiation protective glasses was 1.8%, it was learned that none of the residents used radioprotective gloves. Only 5.3% of the residents stated that they are trained in subjects about the harmful radiation effect. Conclusion: Urology residents in Turkey do not receive sufficient training on the harmful effects of fluoroscopy, which they frequently use in their daily practice. In addition, the residents whom training in university hospitals are more scared of the radiation exposure from fluoroscopy than their colleagues working in training and research hospitals.

Download Full-text

Knowledge, attitude, and behaviour of Turkish dentists regarding contamination and prevention of Hepatitis B, Hepatitis C and HIV infection

Padjadjaran Journal of Dentistry ◽

10.24198/pjd.vol30no3.19305 ◽

2018 ◽

Vol 30 (3) ◽

pp. 198

Author(s):

Merve Koseoglu ◽

Hande Toptan ◽

Selma Altindis

Keyword(s):

Hepatitis C ◽

Hepatitis B ◽

Hiv Infection ◽

Dental Treatment ◽

Hiv Infections ◽

University Hospital ◽

Knowledge Level ◽

University Hospitals ◽

The University ◽

Demographic Features

Introduction: Dentists are at risk of Hepatitis B, Hepatitis C, and HIV infections in their professional practices. The purpose of this study was to determine the knowledge level, attitude, and behaviours of the Turkish dentists regarding contamination and prevention of Hepatitis B, Hepatitis C, and HIV infections. Methods: After receiving the required ethical and administrative approvals, a 33-item digital survey was applied within the context of the present study, and carried out amongst 58 dentists. Results: According to the results of this study, the knowledge level did not vary between different demographic features (p ˃ 0.05). However, the dentists’ attitude and behaviours were different. Post-exposure attitude towards Hepatitis B, Hepatitis C, and HIV infection did not vary between different demographic features (p ˃ 0.05). Female dentists who received education regarding infectious diseases more often got health check in case of injury (p ˂ 0.05). Female dentists felt more concerned than male dentists when they were treating infected patients, and they were more often using protective barriers (p ˂ 0.05). Dentists who were working at the university hospital and public hospital mostly had their Hepatitis B vaccinations more often than private clinics, also, dentists in university hospitals more often reported prefer to treat infected patients (p ˂ 0.05). Dentists who did not receive any education have reported that dental treatment of infected patients should be performed in specialised clinics (p ˂ 0.05). Conclusion: The Turkish dentists’ knowledge level, attitude, and behaviour were different. According to the findings of this study, efficacious education programs should be prepared for dentists to establish a positive attitude towards Hepatitis B, Hepatitis C, and HIV infected patients.Keywords: Dentists, Turkish, Hepatitis B virus, Hepatitis C virus, HIV.

Download Full-text

Effect of Educational Programs, Rigid Sharps Containers, and Universal Precautions on Reported Needlestick Injuries in Healthcare Workers

Infection Control and Hospital Epidemiology ◽

10.1086/646327 ◽

1991 ◽

Vol 12 (4) ◽

pp. 214-219 ◽

Cited By ~ 25

Author(s):

Calvin C. Linnemann ◽

Constance Cannon ◽

Martha DeRonde ◽

Bruce Lanphear

Keyword(s):

Infection Control ◽

General Hospital ◽

Educational Program ◽

Healthcare Workers ◽

University Hospital ◽

Needlestick Injuries ◽

Universal Precautions ◽

Control Programs ◽

University Of Cincinnati ◽

The University

AbstractObjective:To evaluate the effect of infection control programs on reported needlestick injuries in a general hospital.Design:Surveillance of all reported needlestick injuries at the University of Cincinnati Hospital was maintained by the infection control department for five years, from 1985 through 1989. Data on individual workers were collected, tabulated on a monthly basis, and reviewed continually to monitor trends in injuries. During this time, the effects of each of three new infection control programs on reported injuries were evaluated sequentially.Setting:A 700-bed general hospital that serves as the main teaching hospital of the University of cincinnati.Participants:All employees of University Hospital who reported to personnel health for management of needlestick injuries.Interventions:In 1986, an educational program to prevent injuries was initiated and continued throughout the surveillance period. In 1987, rigid sharps disposal containers were placed in all hospital rooms. In 1988, universal precautions were introduced with an intensive inservice.Results:Surveillance identified 1,602 needlestick injuries (320/year) or 104/1 ,000/ year. After the educational program began, reported injuries increased rather than decreased, and this was attributed to increased reporting. Subsequently, after installation of the new disposal containers, reported injuries returned to the levels seen prior to the educational program, but recapping injuries showed a significant decrease from 63/year to 30, or 20/1,000/year to 10. This decrease was observed in nurses but not in other healthcare workers. After universal precautions were instituted, total injuries increased slightly, but recapping injuries remained at 50% of the levels reported prior to the use of rigid sharps disposal containers.Conclusions: The three infection control programs failed to produce a major reduction in reported needlestick injuries, except for a decrease in recapping injuries associated with the placement of rigid sharps disposal containers in all patient rooms. These observations indicate that new approaches are needed to reduce needlestick injuries.

Download Full-text