A Metaphoric Design of Electronic Medical Record (EMR) for Periodic Health Examination Reports

The exponential growth of big data demands an efficient knowledge discovery. The electronic medical records of patients on medical data Clouds contain implicit medical information. Although the periodic health examination (PHE) reports describing a set of screening tests for healthy individuals performed periodically, common individuals require the assistance of an expert to interpret the results for a medical opinion. This research study proposes a metaphoric design of Electronic Medical Record (EMR) for PHE reports of patients. The outcomes of this study glimpses useful findings for the common people in the self-interpretation of their medical reports. Besides, among a variety of solutions, the study uses the metaphoric representation to convert the numerical data and medical terminology to familiar graphic representations from real life. The study identifies the detailed requirements to propose a conceptual architecture for metaphoric EMR reports. The future work will result in a prototype design, evaluation, and refinement of metaphors based on stakeholders' feedback.

Semantic models for assessing the influence of a combination of factors on the development of diseases

The analysis of approaches and solutions to the problem of risk assessment and prognosis of conditions and development of diseases is presented. It is shown that the implementation of software services on various platforms complicates the possibility of their comprehensive use and the choice between the available solutions. This has risen the urgency of creating a unified semantic model of diseases that integrates various methods and approaches to solving this problem and accumulates knowledge about risks and prognosis in a unified information space. A new semantic model is proposed to take into account influence of a combination of factors on development of various events that threaten health and life. The feature of the model is its independence from a specific disease or a group of diseases, which allows it to be used in various branches of medicine. This model has been tested on the IACPaaS platform. A software solver has been implemented that allows generating a clear explanation based on the knowledge base and analysis of the patient's electronic medical record. The application of the new model for the formation of knowledge is shown on the example of risk assessment and prognosis of cardiovascular events.

SARS-CoV-2 vaccine effectiveness and breakthrough infections in maintenance dialysis patients

Background: SARS-CoV-2 vaccine effectiveness during the Delta period and immunogenicity threshold associated with protection against COVID-19 related hospitalization or death in the dialysis population is unknown. Methods: A retrospective, observational study assessed SARS-CoV-2 vaccine effectiveness and immunogenicity threshold in all adult maintenance dialysis patients without COVID-19 history treated between February 1 and October 2, 2021. All COVID-19 infections, composite of hospitalization or death following COVID-19 and available SARS-CoV-2 anti-spike immunoglobulin (Ig) G values were extracted from electronic medical record. COVID-19 cases per 10,000 days at risk and vaccine effectiveness during pre-Delta and Delta periods were determined. Results: Of 15,718 patients receiving dialysis during the study period, 11,191 (71%) were fully vaccinated, 733 (5%) were partially vaccinated and 3,794 (24%) were unvaccinated. 967 COVID-19 were cases identified: 511 (53%) occurred in unvaccinated patients and 579 (60%) occurred during the Delta period. COVID-19 related hospitalization or death was less likely among vaccinated versus unvaccinated patients for all vaccines (adjusted HR 0.19 [0.12, 0.30]) and for BNT162b2/Pfizer, mRNA-1273/Moderna, and Ad26.COV2.S/Janssen (adjusted HR=0.25 [0.16, 0.40], 0.14 [0.08, 0.22], and 0.34 [0.17, 0.68] respectively). Among those with anti-spike IgG levels, those with IgG level ≥ 7 had significantly lower risk of a COVID-19 diagnosis (HR=0.25 [0.15, 0.42]) and none experienced a COVID-related hospitalization or death. Conclusions: Among maintenance dialysis patients, SARS-CoV-2 vaccination was associated with a lower risk of COVID-19 diagnosis and associated hospitalization or death. Among vaccinated patients, low anti-spike IgG level is associated with worse COVID-19 related outcomes.

Perioperative Nurses’ Perceptions Pre-Implementation of an Electronic Medical Record System

The use of electronic medical record (EMR) systems is transforming health care delivery in hospitals. Perioperative nurses work in a unique high-risk health setting, hence require specific considerations for EMR implementation. This research explored perioperative nurses’ perceptions of facilitators and barriers to the implementation of an EMR in their workplace to make context-specific recommendations about strategies to optimise EMR adoption. Using a qualitative exploratory descriptive design, focus group data were collected from 27 perioperative nurses across three hospital sites. Thematic analyses revealed three themes: 1) The world is going to change; 2) What does it mean for me? and 3) We can do it, but we have some reservations. Mapping coded data to the Theoretical Domains Framework identified prominent facilitators and barriers, and informed recommended implementation strategies for EMR adoption by perioperative nurses.