Descriptive Observational Study of Tdap Vaccination Adhesion in Pregnant Women in the Florentine Area (Tuscany, Italy) in 2019 and 2020

Background: Tdap (Tetanus-Diphtheria-acellular Pertussis) vaccination is nowadays a worldwide-recommended practice to immunize pregnant women. The vaccine administration at the third trimester of pregnancy (as recommended by the WHO) would ensure antibody protection to both the mother and the newborn and has contributed to the significant drop of pertussis cases in infants. The aim of this observational study was to describe for the first time the socio-demographic characteristics and determinants of Tdap vaccination adhesion of pregnant women in the Florentine area. Methods: Information about parents’ vaccination status, their citizenship, employment type and mothers’ previous pregnancies and/or abortions were collected at the time of birth through the assistance birth certificates (CedAP) both for the years 2019 and 2020. This archive and the regional SISPC (Collective Prevention Healthcare Information System) linked using an anonymous unique personal identifier to retrieve the mother’s vaccination status. Results: We found an overall Tdap vaccination adhesion of 43% in 2019 and 47.3% in 2020. Several socio-demographic parameters would determine an increased vaccination adhesion, including parents’ geographical origin, mothers’ age and educational background, as well as the number of previous deliveries, abortions or voluntary termination of pregnancy. Conclusions: Since not much data are available on this topic in Italy, this study may constitute the baseline information for Tdap vaccination adhesion in pregnant women in the Florentine area (Italy). Thus, future successful vaccination strategies may be designed accordingly.

The Process of Modeling Information System Architectures with IHE

IHE has defined more than 200 integration profiles in order to improve the interoperability of application systems in healthcare. These profiles describe how standards should be used in particular use cases. These profiles are very helpful but their correct use is challenging, if the user is not familiar to the specifications. Therefore, inexperienced modelers of information systems quickly lose track of existing IHE profiles. In addition, the users of these profiles are often not aware of rules that are defined within these profiles and of dependencies that exist between the profiles. There are also modelers that do not notice the differences between the implemented actors, because they do not know the optional capabilities of some actors. The aim of this paper is therefore to describe a concept how modelers of information systems can be supported in the selection and use of IHE profiles and how this concept was prototypically implemented in the “Three-layer Graph-based meta model” modeling tool (3LGM2 Tool). The described modeling process consists of the following steps that can be looped: defining the use case, choosing suitable integration profiles, choosing actors and their options and assigning them to application systems, checking for required actor groupings and modeling transactions. Most of these steps were implemented in the 3LGM2 Tool. Further implementation effort and evaluation of our approach by inexperienced users is needed. But after that our tool should be a valuable tool for modelers planning healthcare information system architectures, in particular those based on IHE.

A Novel Approach for Healthcare Information System using Cloud

The main objective of this paper is to outline a Cloud Computing based Healthcare Information System that helps bridge the gap between various hospitals, patients and clinics by creating a central hub of patient details and health care history that is accessible via two interfaces- either the mobile app or the web application.

COVID-19 vs. Healthcare Information System Self-Efficacy Perception (HISSEP)

Coronavirus has emphasized the importance of nursing contributions and their integral participation in interdisciplinary leadership teams providing patient care in healthcare organizations. Workforce shortages of qualified nurses in healthcare with technology skills are necessary to maintain a high level of patient care and healthcare operations. A validated instrument, Healthcare Information System Self-Efficacy Perception, was created providing a self-assessment tool for measuring an older working nurse's perception of self-efficacy of healthcare information system training within a healthcare environment. The study was the first of its kind to recognize the salient training differences that existed for older workers in a healthcare setting. The instrument was developed using a focus group, pilot study, and validated with registered nurses (RN) in a single healthcare organization. The sample (N=162) was assessed using an online survey tool. After face validity was established for HISSEP, a principal component factor analysis was conducted to determine content validity.

Sustainable Smart Healthcare Information Portfolio Strategy Evaluation: An Integrated Activity-Based Costing Decision Model

Smart city and smart hospital development comprise a mainstream strategy worldwide to enhance the achievement of Sustainable Development Goals (SDGs) and Corporate Social Responsibility (CSR) practices. The smart healthcare industry needs to optimize its smart healthcare information strategies, creating the process-activity value and reducing the cost of healthcare without sacrificing the quality of patient care. This study proposes an decision model of Activity-Based Costing (ABC) concept and Multi-Criteria Decision-Making (MCDM) techniques that integrates the Decision-Making Trial and Evaluation Laboratory (DEMATEL), Analytic Network Processes (ANP), the VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) and Zero-One Goal Programming (ZOGP) to achieve optimal smart healthcare information system portfolio strategy decisions. The resulting data shows that the perspective of government policy support and the criterion of Minimize Equipment Maintenance Costs are the most significant evaluation factors, and that the Health Data Informational System and Hospital Device and Drug Management System comprise by far the optimal portfolio of smart healthcare information system which strengthen the connection between ABC and MCDM techniques in evaluation process. The major contributions of this study are as follows: (1) the proposed model contributes to the management accounting innovation development of a sustainable city and Operation Research (OR) application; (2) the integrated model can promote the smart healthcare industry development and help decision makers to more accurately understand how to allocate resources and planning for intelligent-related activities to each smart healthcare information system through appropriate cost drivers.

A Comparison of Modern Frameworks for the Development of Interoperable Healthcare Information Systems

Despite the strong consensus behind the need for an interoperable Healthcare Information System (HIS), the universal acceptance of a standard HIS framework has advanced very little and is yet to become a market reality. In an effort to advance this endeavor, this work provides a systematic comparison regarding two of the most relevant HIS frameworks recently proposed: The Integrated Clinical Environment (ICE) and the Healthcare Industry 4.0 Framework. The paper analyzes their differences and similarities and proposes a minimum set of requirements for prospective interoperable HIS architectures compliant with the Industry 4.0 design principles, goal-setting pillars, as well as support for closed-loop physiological systems. Finally, the paper discusses future works in the field.