bluuebunny/crossref_metadata_2025 huggingface dataset:
From Data Mining Rules to Medical Logical Modules and Medical Advices
Authors: Gomoi Valentin  , Vida Mihaela  , Robu Raul  , Stoicu-Tivadar Vasile  , Bernad Elena  , Lupşe Oana
Published: February 2025

Using data mining in collaboration with Clinical Decision Support Systems adds new knowledge as support for medical diagnosis. The current work presents a tool which translates data mining rules supporting generation of medical advices to Arden Syntax formalism. The developed system was tested with data related to 2326 births that took place in 2010 at the Bega Obstetrics – Gynaecology Hospital, Timişoara. Based on processing these data, 14 medical rules regarding the Apgar score were generated and then translated in Arden Syntax language.
Enhancing Research Capacity of African Institutions through Social Networking
Authors: Jimenez-Castellanos Ana  , Ramirez-Robles Maximo  , Shousha Amany  , Bagayoko Cheick Oumar  , Perrin Caroline  , Zolfo Maria  , Cuzin Asa  , Roland Alima  , Aryeetey Richmond  , Maojo Victor
Published: February 2025

Traditionally, participation of African researchers in top Biomedical Informatics (BMI) scientific journals and conferences has been scarce. Looking beyond these numbers, an educational goal should be to improve overall research and, therefore, to increase the number of scientists/authors able to produce and publish high quality research. In such scenario, we are carrying out various efforts to expand the capacities of various institutions located at four African countries – Egypt, Ghana, Cameroon and Mali – in the framework of a European Commission-funded project, AFRICA BUILD. This project is currently carrying out activities such as e-learning, collaborative development of informatics tools, mobility of researchers, various pilot projects, and others. Our main objective is to create a self-sustained South-South network of BMI developers.
Analysis of the Interface and Data Transfer from ICU to Normal Wards in a German University Hospital
Authors: Vollmer Anne-Maria  , Skonetzki-Cheng Stefan  , Prokosch Hans-Ulrich
Published: February 2025

Typically general wards and intensive care units (ICU) have very different labor organizations, structures and IT-systems in Germany. There is a need for coordination, because of the different working arrangements. Our team investigated the interface between ICU and general ward and especially the respective information transfer in the University hospital in Erlangen (Bavaria, Germany). The research team used a combination of interviews, observations and the analysis of transfer records and forms as part of a methodical triangulation. We identified 41 topics, which are discussed or presented in writing during the handover. In a second step, we investigate the requirements of data transmission in expert interviews. A data transfer concept from the perspective of the nurses and physicians was developed and we formulated recommendations for improvements of process and communication for this interface. Finally the data transfer concept was evaluated by the respondents.
Can we bridge the definition diversity in healthcare-associated infection surveillance? From IT-supported surveillance to IT-supported infection prevention and control
Authors: Koller Walter  , Blacky Alexander  , Mandl Harald  , Rappelsberger Andrea  , Adlassnig Klaus-Peter
Published: February 2025

Expectations and requirements of the surveillance of healthcare-associated infections (HAIs) trigger a growing differentiation of HAI surveillance approaches. In an attempt to bridge this diversity of definitions and to serve the needs of different user groups, we have enhanced MONI (identification, monitoring, and reporting of nosocomial infections) not only to create better reports, but also to output overviews on complex clinical matters, as well as to generate alerts and reminders for the clinicians' bedside work.
Development and Evaluation of an Electronic Health Record Configuration and Customization Laboratory Course for Clinical Informatics Students
Authors: Mohan Vishnu  , Hersh William R.
Published: February 2025

Objectives: There is a need for informatics educational programs to develop laboratory courses that facilitate hands-on access to an EHR, and allow students to learn and evaluate functionality and configuration options. This is particularly relevant given the diversity of backgrounds of informatics students.
Piloting a National Laboratory Electronic Programme Status Reporting System
Authors: Cassim Naseem  , Coetzee Lindi  , Motlonye Bahule  , Mpele Nobantu  , Glencross Deborah K.
Published: February 2025

The NHLS performs close to 4 million CD4 tests per annum for the public sector in South Africa through a network of 60 CD4 testing laboratories. CD4 laboratory data provides an assessment of the number of patients on ART and HIV-positive patients in the pre-ART wellness programs. This study aims to develop a laboratory based Comprehensive Care, Management and Treatment of HIV and AIDS (CCMT) programme status reporting system for CD4 testing at three health facilities in the Ekurhuleni health district using a newly developed CCMT request form, the Laboratory Information System (LIMS) and Corporate Data Warehouse (CDW). The study will generate monitoring and evaluation data to assist in the management of health facilities through a national electronic corporate data warehouse.
App-Synopsis – Standard Reporting for Medical Apps
Authors: Albrecht Urs-Vito  , von Jan Ute  , Jungnickel Tobias  , Pramann Oliver
Published: February 2025

The market for medical apps is rapidly expanding – both for professional use as well as for patient centered apps. There are numerous medical apps, but relevant information about their limitations and dangers is rarely available. In an exemplary evaluation of n=8 medical apps, deficits regarding data integrity, one half had security and privacy issues. Since standard users usually have neither the equipment, know-how nor time for such analyses before entrusting them with their data, ideally, manufacturers should provide information regarding the functionality and limits of their products. Mandatory information should cover data management, data protection and privacy issues. To increase transparency, a standardized reporting tool in the form of an app synopsis could be helpful for providing the necessary information.
Natural Language Processing and Inference Rules as Strategies for Updating Problem List in an Electronic Health Record
Authors: Plazzotta Fernando  , Otero Carlos  , Luna Daniel  , de Quiros Fernan Gonzalez Bernaldo
Published: February 2025

Physicians do not always keep the problem list accurate, complete and updated. Objective: To analyze natural language processing (NLP) techniques and inference rules as strategies to maintain completeness and accuracy of the problem list in EHRs. Methods: Non systematic literature review in PubMed, in the last 10 years. Strategies to maintain the EHRs problem list were analyzed in two ways: inputting and removing problems from the problem list. Results: NLP and inference rules have acceptable performance for inputting problems into the problem list. No studies using these techniques for removing problems were published Conclusion: Both tools, NLP and inference rules have had acceptable results as tools for maintain the completeness and accuracy of the problem list.
Exploring the Potential of an Electronic Documentation System to Reduce Length of Stay
Authors: Mantas John  , Zikos Dimitrios  , Diomidous Marianna
Published: February 2025

Electronic patient records are important in patient data management. Aim of this 2-year study was to investigate the effect of an e-documentation system on the ED length of stay. The study compared three length of stay parameters with and without the use of a prototype e-documentation system. 99 of trauma patients were monitored with the use of the electronic system and 101 patients (control group) were monitored with traditional methods. Time between the admission and completion of care was significantly lower in the e-documentation group (100±92 minutes, control group: 149±29 minutes). Similar effect was also found to the total ED length of stay (127±93 vs. 206±41 minutes) and time between completion of care and ED exit (26±10 vs. 57±23 minutes). LOS was reduced with the e-documentation system. This is important for the quality of trauma patient care, since saving time during the first hours after the accident usually determines the outcome of trauma patients.
ResearcherMap: A Tool for Visualizing Author Locations Using Google Maps
Authors: Rastegar-Mojarad Majid  , Bales Michael E.  , Yu Hong
Published: February 2025

We hereby present ResearcherMap, a tool to visualize locations of authors of scholarly papers. In response to a query, the system returns a map of author locations. To develop the system we first populated a database of author locations, geocoding institution locations for all available institutional affiliation data in our database. The database includes all authors of Medline papers from 1990 to 2012. We conducted a formative heuristic usability evaluation of the system and measured the system's accuracy and performance. The accuracy of finding the accurate address is 97.5% in our system.
Medication Extraction and Guessing in Swedish, French and English
Authors: Hamon Thierry  , Grabar Natalia  , Kokkinakis Dimitrios
Published: February 2025

Extraction of information related to the medication is an important task within the biomedical area. Our method is applied to different types of documents in three languages. The results indicate that our approach can efficiently update and enrich the existing drug vocabularies.
Time-dependent Migration of Citations Through PubMed and OvidSP Subsets: a Study on a Series of Simultaneous PubMed and OvidSP Searches
Authors: Boeker Martin  , Vach Werner  , Motschall Edith
Published: February 2025

OBJECTIVE: To quantitatively describe (1) differences between search results derived at consecutive time points with the PubMed and OvidSP literature search interfaces over a five day interval, and (2) the migration of citations through different subsets to estimate the timeliness of OvidSP.
Tracking and Visualizing Headache Trends on a Mobile or Desktop Website
Authors: Filipi Jennifer M.  , Khairat Saif
Published: February 2025

Many people suffering from chronic headaches use headache diaries to help track trends in their episodes. Studies have shown that electronic headache diaries are more effective than paper diaries for both patients and providers. We designed and implemented a full-size and mobile Web-based headache tracker and a database management system to store the data from the websites. The full-size website allows users to retrieve their data by viewing or downloading a table of the raw values they entered, or they can see a graphical visualization linking the severity of their headaches to any of several variables. Through this system's capacity to illustrate trends and track contributing factors for headaches, users, researchers and health service providers may gain better understanding of and control over chronic headaches.
Exploring the Possibility of Modeling a Genetic Counseling Guideline Using Agile Methodology
Authors: Choi Jeeyae
Published: February 2025

Increased demand of genetic counseling services heightened the necessity of a computerized genetic counseling decision support system. In order to develop an effective and efficient computerized system, modeling of genetic counseling guideline is an essential step. Throughout this pilot study, Agile methodology with United Modeling Language (UML) was utilized to model a guideline. 13 tasks and 14 associated elements were extracted. Successfully constructed conceptual class and activity diagrams revealed that Agile methodology with UML was a suitable tool to modeling a genetic counseling guideline.
Preliminary Evaluations of a Spoken Web Enabled Care Management Platform
Authors: Padman Rema  , Beam Erika  , Szewczyk Rachel
Published: February 2025

Telephones are a ubiquitous and widely accepted technology worldwide. The low ownership cost, simple user interface, intuitive voice-based access and long history contribute to the wide-spread use and success of telephones, and more recently, that of mobile phones. This study reports on our preliminary efforts to leverage this technology to bridge disparities in the access to and delivery of personalized health and wellness care by developing and evaluating a Spoken Web enabled Care Management solution. Early results with two proxy evaluations and a few visually impaired users highlight both the potential and challenges associated with this novel, voice-enabled healthcare delivery solution.
A Course to Teach Students to Learn Mobile Health by Serving the Elderly
Authors: Kuo Ming Chuan  , Su Yu-Ting  , Chen Jin-Jong  , Lee Chen-Hsen  , Chang Polun
Published: February 2025

We designed a special course based on Service Learning theory to train the undergraduate students to teach the elderly people in community college to learn using smartphones for health. A 2-credit course was designed, composed of lecture & discussion and community service. 20 undergrduate stundents from university and 26 seniors from community college registered at this course. The results show very postitive impacts in both groups. The students felt doing something meaningful and learning helping the elder when the elderly felt very appreciated by being served and taught by students about the smartphones. The elderly wished us to go back in the future.
Analysis of Network Based Co-Expression Modules for Alzheimer's Disease
Authors: Dua Prerna  , Bais Sonali  , Lukiw Walter J.
Published: February 2025

There has been an intensive research going on for Alzheimer's disease (AD) to understand its cause and progression through the past decade. However, the pathogenic factors that are responsible for these processes are still unclear. In this research we utilize the hippocampal gene expression data of 22 AD patients and present a framework for a comparative study to evaluate the two similarity measures, Mutual Information and Pearson Correlation Coefficient in developing gene coexpression networks. We hypothesize that Mutual Information based co-expression networks can capture more biologically significant dependencies as compared to Pearson Correlation Coefficient due to its ability to capture non-linear relationships. We utilize a parameter free module discovery algorithm to detect functional modules discovered by the two approaches. Further, to validate our approach, we compared the identified functional modules resulted by our experiments to the existing biological modules by computing the Jaccard index between them. Finally, we evaluated the discovered modules for their biological significance by performing biomedical literature search. We also investigated the drug interdiction pathways, which suggest potential targets for intervention.
Efficiency Strategies for Facilitating Computerized Clinical Documentation in Ambulatory Care
Authors: Saleem Jason J  , Adams Stephanie  , Frankel Richard M.  , Doebbeling Bradley N.  , Patterson Emily S.
Published: February 2025

Most providers have experienced increased documentation demands with the use of electronic health records (EHRs). We sought to identify efficiency strategies that providers use to complete clinical documentation tasks in ambulatory care. Two observers performed ethnographic observations and interviews with 22 ambulatory care providers in a U.S. Veterans Affairs Medical Center. Observation notes and interview transcripts were coded for recurrent strategies relating to completion of the EHR progress notes. Findings included: the use of paper artifacts for handwritten notations; electronic templates for automation of certain parts of the note; use of shorthand and phrases rather than narrative writing; copying and pasting from previous EHR notes; directly entering information into the EHR note during the patient encounter; reliance on memory; and pre-populating an EHR note prior to seeing the patient. We discuss the findings in the context of distributed cognition to understand how clinical information is propagated and represented toward completion of a progress note. The study findings have important implications for improving and streamlining clinical documentation related to human factors workload management strategies.
Ontologies to Improve Chronic Disease Management Research and Quality Improvement Studies – A Conceptual Framework
Authors: Liyanage Harshana  , Liaw Siaw-Teng  , Kuziemsky Craig  , de Lusignan Simon
Published: February 2025

There is a growing burden of chronic non-communicable disease (CNCD). Managing CNCDs requires use of multiple sources of health and social care data, and information about coordination and outcomes. Many people with CNCDs have multimorbidity. Problems with data quality exacerbate challenges in measuring quality and health outcomes especially where there is multimorbidity. We have developed an ontological toolkit to support research and quality improvement studies in CNCDs using heterogeneous data, with diabetes mellitus as an exemplar. International experts held a workshop meeting, with follow up discussions and consensus building exercise. We generated conceptual statements about problems with a CNCD that ontologies might support, and a generic reference model. There were varying degrees of consensus. We propose a set of tools, and a four step method: (1) Identification and specification of data sources; (2) Conceptualisation of semantic meaning; (3) How available routine data can be used as a measure of the process or outcome of care; (4) Formalisation and validation of the final ontology.
PPADS: Physician-PArent Decision-Support for Neonatal Intensive Care
Authors: Frize Monique  , Bariciak Erika  , Gilchrist Jeff
Published: February 2025

Family-centered care is becoming the new standard for Neonatal Intensive Care Unit (NICU) patients. In support of this, we developed the Physician PArent Decision Support System (PPADS), which provides clinical updates and predictions of clinical outcomes for infants in the NICU to the neonatologists, and provides an aid to parents for making difficult decisions on the direction of care of their infant with the health care team. The tool may lead to earlier intervention, better allocation of resources, and reduction of the negative outcomes. The tool underwent a usability study with 8 parents whose infant survived the NICU stay and 5 neonatologists. Both parents and physicians thought the tool was easy to use, useful, and would help improve team communication. The next usability study will be with parents whose infant died while in the NICU, and then conduct a randomized prospective study with parents who have a sick infant admitted to the NICU.
A Qualitative Study of Swedes' Opinions about Shared Electronic Health Records
Authors: Lehnbom Elin C.  , McLachlan Andrew J.  , Brien Jo-anne E.
Published: February 2025

European countries are world-leading in the development and implementation of e-Health. In Sweden, all primary healthcare centres and most hospitals use digital records. Some regions use the same software which allows for clinical information to be shared (regionally shared EHRs), but there is a movement towards making all EHRs inter-operable to allow for a National Patient Summary (NPS). The aim of this study was to explore the opinions of Swedish consumers and health professionals about shared EHRs and the NPS. Semi-structered phone interviews were conducted with consumers and health professionals. The majority of interviewed health professionals were currently using regionally shared EHRs. In their experience, having access to regionally shared EHRs facilitated a holistic patient approach, assisted in patient follow-up, and reduced inappropriate (over)prescribing. Consumers had a poor level of knowledge about shared EHRs and the NPS. Unlike health professionals, consumers perceived a NPS to be of great value. The findings indicate that there was a discrepancy between health professionals and consumers' knowledge of, and the perceived need for, a NPS.
Routine Use of the “ADE Scorecards”, an Application for Automated ADE Detection in a General Hospital
Authors: Chazard Emmanuel  , Luyckx Michel  , Beuscart Jean-Baptiste  , Ferret Laurie  , Beuscart Régis
Published: February 2025

Retrospective detection of Adverse Drug Events (ADEs) is challenging, notably because ADEs result from complex interactions between many factors. Data mining techniques have recently emerged in the field of automated retrospective ADE detection. The “ADE Scorecards” are a research application based on data-mining that has been built in the framework of the PSIP European Project, and potentially enables automated ADE retrospective detection. The objective of this paper is to evaluate the use of the ADE Scorecards in a real-life healthcare situation. For that purpose, the ADE Scorecards have been implemented in a French general hospital and have been used by the physicians and pharmacists for three years (corresponding to 73,000 inpatient stays). According to the results, 2% of the analyzed inpatient stays have a potential ADE with hyperkalemia, and 1% of them have a potential ADE with vitamin K antagonist overdose. In practice, the application, which was first designed to be a standalone web-based application for the physicians, has been used as a part of a more global quality improvement approach led by the pharmacists.
Enabling Outsourcing XDS for Imaging on the Public Cloud
Authors: Ribeiro Luís S.  , Rodrigues Renato P.  , Costa Carlos  , Oliveira José Luís
Published: February 2025

Picture Archiving and Communication System (PACS) has been the main paradigm in supporting medical imaging workflows during the last decades. Despite its consolidation, the appearance of Cross-Enterprise Document Sharing for imaging (XDS-I), within IHE initiative, constitutes a great opportunity to readapt PACS workflow for inter-institutional data exchange. XDS-I provides a centralized discovery of medical imaging and associated reports. However, the centralized XDS-I actors (document registry and repository) must be deployed in a trustworthy node in order to safeguard patient privacy, data confidentiality and integrity. This paper presents XDS for Protected Imaging (XDS-p), a new approach to XDS-I that is capable of being outsourced (e.g. Cloud Computing) while maintaining privacy, confidentiality, integrity and legal concerns about patients' medical information.
An Information and Communication Technology System to Detect Hypoglycemia in People with Type 1 Diabetes
Authors: Jensen Morten Hasselstrøm  , Christensen Toke Folke  , Tarnow Lise  , Johansen Mette Dencker  , Hejlesen Ole Kristian
Published: February 2025

Continuous glucose monitoring (CGM) is a new technology with the potential to detect hypoglycemia in people with Type 1 diabetes. However, the inaccuracy of the device in the hypoglycemic range is unfortunately too large. The aim of this study was to develop an information and communication technology system for improving hypoglycemia detection in CGM. The system was developed as an Android application with a build-in pattern classification algorithm. The algorithm processes features from CGM and typed in data from the patient, then warns the patient about incoming hypoglycemia. The system improved the detection of hypoglycemic events by 29%, with only one 1 false alert compared to CGM alone. Furthermore, the algorithm increased the average lead-time by 14 minutes. These findings indicate that it is possible to improve the hypoglycemia detection with an information and communication technology system, but that the system must be validated on a larger dataset.
Usability Evaluation of Family Physicians' Interaction with the Comorbidity Ontological Modeling and ExecuTion System (COMET)
Authors: Abidi Samina R.  , Stewart Samuel  , Shepherd Michael  , Abidi Syed Sibte Raza
Published: February 2025

Objective: To assess how well the COMET system meets the functional goals and usability needs of family physicians (FP) for the management of patients who have comorbid chronic heart failure (CHF) and atrial fibrillation (AF).
A System for Automated General Medical Diagnosis using Bayesian Networks
Authors: Zagorecki Adam  , Orzechowski Piotr  , Hołownia Katarzyna
Published: February 2025

In this paper we present a computer-assisted diagnostic system for general medical diagnosis developed using Bayesian network methodology and a medical data base created by experts. The system is intended for the general public as a self-diagnostic tool and is available online free of charge (currently only in Polish, with an English version to be released soon). It serves as an educational self-diagnostic tool intended to encourage the user to visit a doctor if the system so suggests, as is most often the case. In this paper we discuss the underlying modeling principles: assumptions behind Bayesian network architecture, solutions to scalability challenges, and computation performance. The distributed software architecture is presented, and finally, initial results based on over 97,000 diagnoses are discussed. The results suggest that the most common health problems for the young generation in Poland (typical user profile) are those resulting from stress and an unhealthy lifestyle.
Automatic De-Identification of French Clinical Records: Comparison of Rule-Based and Machine-Learning Approaches
Authors: Grouin Cyril  , Zweigenbaum Pierre
Published: February 2025

In this paper, we present a comparison of two approaches to automatically de-identify medical records written in French: a rule-based system and a machine-learning based system using a conditional random fields (CRF) formalism. Both systems have been designed to process nine identifiers in a corpus of medical records in cardiology. We performed two evaluations: first, on 62 documents in cardiology, and on 10 documents in foetopathology – produced by optical character recognition (OCR) – to evaluate the robustness of our systems. We achieved a 0.843 (rule-based) and 0.883 (machine-learning) exact match overall F-measure in cardiology. While the rule-based system allowed us to achieve good results on nominative (first and last names) and numerical data (dates, phone numbers, and zip codes), the machine-learning approach performed best on more complex categories (postal addresses, hospital names, medical devices, and towns). On the foetopathology corpus, although our systems have not been designed for this corpus and despite OCR character recognition errors, we obtained promising results: a 0.681 (rule-based) and 0.638 (machine-learning) exact-match overall F-measure. This demonstrates that existing tools can be applied to process new documents of lower quality.
Epistemonikos: A Free, Relational, Collaborative, Multilingual Database of Health Evidence
Authors: Rada Gabriel  , Pérez Daniel  , Capurro Daniel
Published: February 2025

Epistemonikos (www.epistemonikos.org) is a free, multilingual database of the best available health evidence. This paper describes the design, development and implementation of the Epistemonikos project. Using several web technologies to store systematic reviews, their included articles, overviews of reviews and structured summaries, Epistemonikos is able to provide a simple and powerful search tool to access health evidence for sound decision making. Currently, Epistemonikos stores more than 115,000 unique documents and more than 100,000 relationships between documents. In addition, since its database is translated into 9 different languages, Epistemonikos ensures that non-English speaking decision-makers can access the best available evidence without language barriers.
Hidden Markov Model for Analyzing Time-Series Health Checkup Data
Authors: Kawamoto Ryouhei  , Nazir Alwis  , Kameyama Atsuyuki  , Ichinomiya Takashi  , Yamamoto Keiko  , Tamura Satoshi  , Yamamoto Mayumi  , Hayamizu Satoru  , Kinosada Yasutomi
Published: February 2025

In this paper, we apply a Hidden Markov Model (HMM) to analyze time-series personal health checkup data. HMM is widely used for data having continuation and extensibility such as time-series health checkup data. Therefore, using HMM as probabilistic model to model the health checkup data is considered to be suitable, and HMM can express the process of health condition changes of a person. In this paper, a HMM with six states placed in a 2×3 matrix was prepared. We collected training features including the time-series health checkup data. Each feature consists of eight inspection parameters such as BMI, SBP, and TG. The HMM was then built using the training features. In the experiments, we built five HMMs for different gender and age conditions (e.g. male 50's) using thousands of training feature vectors, respectively. Investigating the HMMs we found that the HMMs can model three health risk levels. The models can also represent health transitions or changes, indicating the possibility of estimating the risk of lifestyle-related diseases.
Citizens and Personal Health Records – the Case of Nelson Mandela Bay
Authors: Pottas Dalenca  , Mostert-Phipps Nicky
Published: February 2025

This paper explores citizen attitudes towards personal health records. The study was conducted in the Eastern Cape Province of South Africa. A cross-sectional design was used and structured questionnaires administered by data collectors. Most respondents (90%) believed it to be important to extremely important for their healthcare provider to have their complete medical records. Less than half of them (42%), however, believed that the healthcare provider did have their complete medical record available to them. Nevertheless, 69% do not keep a medical record as a way to address this concern. Most of them (84%) were not aware of the existence of electronic tools to capture a personal health record prior to participating in the survey. Concerns relating to the use of online PHRs were identified as privacy (58%), lack of time (27%) and a disinterest in computers (22%). It was found that the existence of a medical chronic condition is a strong predictor of keeping a medical record (albeit mostly in paper-based format).
Evaluating the Impact of ICT-tools on Health Care Delivery in Sub-Saharan Hospitals
Authors: Verbeke Frank  , Karara Gustave  , Nyssen Marc
Published: February 2025

This research explores to what extent Information and Communication Technology (ICT)-based information management methods can help to improve efficiency and effectiveness of health services in sub-Saharan hospitals and how clinical information can be made available for secondary use enabling non-redundant reporting of health- and care performance indicators. In the course of a 6 years research effort between 2006 and 2012, it was demonstrated that patient identification, financial management and structured reporting improved dramatically after implementation of well adapted ICT-tools in a set of 19 African health facilities. Real-time financial management metrics helped hospitals to quickly identify fraudulent practices and defective invoicing procedures. Out-patient case load significantly increased compared to the national average, average length of stay has been shortened in 15 of 19 health facilities and global hospital mortality decreased. Hospital workforce-evaluated impact of hospital information system implementation on local working conditions and quality of care was very positive. It was demonstrated that local sub-Saharan health professionals strongly believe in the importance of health information systems.
Engineering Natural Language Processing Solutions for Structured Information from Clinical Text: Extracting Sentinel Events from Palliative Care Consult Letters
Authors: Barrett Neil  , Weber-Jahnke Jens H.  , Thai Vincent
Published: February 2025

Despite a trend to formalize and codify medical information, natural language communications still play a prominent role in health care workflows, in particular when it comes to hand-overs between providers. Natural language processing (NLP) attempts to bridge the gap between informal, natural language information and coded, machine-interpretable data. This paper reports on a study that applies an advanced NLP method for the extraction of sentinel events in palliative care consult letters. Sentinel events are of interest to predict survival and trajectory for patients with acute palliative conditions. Our NLP method combines several novel characteristics, e.g., the consideration of topological knowledge structures sourced from an ontological terminology system (SNOMED CT). The method has been applied to the extraction of different types of sentinel events, including simple facts, temporal conditions, quantities, and degrees. A random selection of 215 anonymized consult letters was used for the study. The results of the NLP extraction were evaluated by comparison with coded sentinel event data captured independently by clinicians. The average accuracy of the automated extraction was 73.6%.
Designing a Mobile Augmented Reality Tool for the Locative Visualisation of Biomedical Knowledge
Authors: Kilby Jess  , Gray Kathleen  , Elliott Kristine  , Waycott Jenny  , Sanchez Fernando Martin  , Dave Bharat
Published: February 2025

Mobile augmented reality (MAR) may offer new and engaging ways to support consumer participation in health. We report on design-based research into a MAR application for smartphones and tablets, intended to improve public engagement with biomedical research in a specific urban precinct. Following a review of technical capabilities and organizational and locative design considerations, we worked with staff of four research institutes to elicit their ideas about information and interaction functionalities of a shared MAR app. The results were promising, supporting the development of a prototype and initial field testing with these staff. Evidence from this project may point the way toward user-centred design of MAR services that will enable more widespread adoption of the technology in other healthcare and biomedical research contexts.
My Care Pathways – Creating Open Innovation in Healthcare
Authors: Lundberg Nina  , Koch Sabine  , Hägglund Maria  , Bolin Peter  , Davoody Nadia  , Eltes Johan  , Jarlman Olof  , Perlich Anja  , Vimarlund Vivian  , Winsnes Casper
Published: February 2025

In this paper we describe initial results from the Swedish innovation project “My Care Pathways” which envisions enabling citizens to track their own health by providing them with online access to their historical, current and prospective future events. We describe an information infrastructure and its base services as well as the use of this solution as an open source platform for open innovation in healthcare. This will facilitate the development of end-user e-services for citizens. We have technically enabled the information infrastructure in close collaboration with decision makers in three Swedish health care regions, and system vendors as well as with National eHealth projects. Close collaboration between heterogeneous actors made implementation in real practice possible. However, a number of challenges, mainly related to legal and business issues, persist when implementing our results. Future work should therefore target the development of business models for sustainable provision of end-user e-services in a public health care system such as the Swedish one. Also, a legal analysis of the development of third party provider (nonhealthcare based) personal health data e-services should be done.
Assessment of the IMIA Educational Accreditation Process
Authors: Mantas John  , Hasman Arie  , Shortliffe Edward H.
Published: February 2025

The International Medical Informatics Association (IMIA) biomedical informatics educational recommendations of 2010 provided an excellent guide for institutions across the world in updating their curricula or establishing new programs. IMIA subsequently decided to offer an accreditation process, guided by the earlier recommendations, to assess existing educational programs in the field of biomedical informatics. This paper presents an overview and SWOT analysis of the accreditation process based on a two-year trial period at three sites across continents. Because other sites are now requesting similar accreditation visits by IMIA, the lessons learned by the committee that performed the assessments during trial period will provide useful guidance for both IMIA and those educational institutions.
Unsupervised Medical Image Classification by Combining Case-Based Classifiers
Authors: Dinh Thien Anh  , Silander Tomi  , Su Bolan  , Gong Tianxia  , Pang Boon Chuan  , Lim C. C. Tchoyoson  , Lee Cheng Kiang  , Tan Chew Lim  , Leong Tze-Yun
Published: February 2025

We introduce an automated pathology classification system for medical volumetric brain image slices. Existing work often relies on handcrafted features extracted from automatic image segmentation. This is not only a challenging and time-consuming process, but it may also limit the adaptability and robustness of the system. We propose a novel approach to combine sparse Gabor-feature based classifiers in an ensemble classification framework. The unsupervised nature of this non-parametric technique can significantly reduce the time and effort for system calibration. In particular, classification of medical images in this framework does not rely on segmentation, nor semantic-based or annotation-based feature selection. Our experiments show very promising results in classifying computer tomography image slices into pathological classes for traumatic brain injury patients.
Consumers' Online Social Network Topologies and Health Behaviours
Authors: Lau Annie Y.S.  , Dunn Adam  , Mortimer Nathan  , Proudfoot Judith  , Andrews Annie  , Liaw Siaw-Teng  , Crimmins Jacinta  , Arguel Amaël  , Coiera Enrico
Published: February 2025

Personally controlled health management systems (PCHMS) often consist of multiple design features. Yet, they currently lack empirical evidence on how consumers use and engage with a PCHMS. An online prospective study was designed to investigate how 709 consumers used a web-based PCHMS to manage their physical and emotional wellbeing over five months. The web-based PCHMS, Healthy.me, was developed at UNSW and incorporates an untethered personal health record, consumer care pathways, forums, polls, diaries, and messaging links with healthcare professionals. The two PCHMS features that consumers used most frequently, found most useful, and engaging were the social features, i.e. forum and poll. Compared to participants who did not use any PCHMS social feature, those who used either the poll or the forum were 12.3% more likely to visit a healthcare professional (P=0.001) during the study. Social network analysis of forums revealed a spectrum of social interaction patterns – from question-and-answer structures to community discussions. This study provides a basis for understanding how a PCHMS can be used as a socially-driven intervention to influence consumers' health behaviours.
Exposing Public Health Surveillance Data Using Existing Standards
Authors: Turbelin Clément  , Boëlle Pierre-Yves
Published: February 2025

With the growing use of information technologies, an increased volume of data is produced in Public Health Surveillance, enabling utilization of new data sources and analysis methods. Public health and research will benefit from the use of data standards promoting harmonization and data description through metadata. No data standard has yet been universally accepted for exchanging public health data. In this work, we implemented two existing standards eligible to expose public health data: Statistical Data and Metadata Exchange – Health Domain (SDMX-HD) proposed by the World Health Organization and Open Data Protocol (OData) proposed by Microsoft Corp. SDMX-HD promotes harmonization through controlled vocabulary and predefined data structure suitable for public health but requires important investment, while OData, a generic purpose standard, proposes a simple way to expose data with minimal documentation and end-user integration tools. The two solutions were implemented and are publicly available at http://sdmx.sentiweb.fr and http://odata.sentiweb.fr. These solutions show that data sharing and interoperability are already possible in Public Health Surveillance.
Method to Integrate Clinical Guidelines into the Electronic Health Record (EHR) by Applying the Archetypes Approach
Authors: Garcia Diego  , Moro Claudia Maria Cabral  , Cicogna Paulo Eduardo  , Carvalho Deborah Ribeiro
Published: February 2025

Clinical guidelines are documents that assist healthcare professionals, facilitating and standardizing diagnosis, management, and treatment in specific areas. Computerized guidelines as decision support systems (DSS) attempt to increase the performance of tasks and facilitate the use of guidelines. Most DSS are not integrated into the electronic health record (EHR), ordering some degree of rework especially related to data collection. This study's objective was to present a method for integrating clinical guidelines into the EHR. The study developed first a way to identify data and rules contained in the guidelines, and then incorporate rules into an archetype-based EHR. The proposed method tested was anemia treatment in the Chronic Kidney Disease Guideline. The phases of the method are: data and rules identification; archetypes elaboration; rules definition and inclusion in inference engine; and DSS-EHR integration and validation. The main feature of the proposed method is that it is generic and can be applied toany type of guideline.
Modeling Decision Support Rule Interactions in a Clinical Setting
Authors: Sordo Margarita  , Rocha Beatriz H.  , Morales Alfredo A.  , Maviglia Saverio M.  , Oglio Elisa Dell'  , Fairbanks Amanda  , Aroy Teal  , Dubois David  , Bouyer-Ferullo Sharon  , Rocha Roberto A.
Published: February 2025

Traditionally, rule interactions are handled at implementation time through rule task properties that control the order in which rules are executed. By doing so, knowledge about the behavior and interactions of decision rules is not captured at modeling time. We argue that this is important knowledge that should be integrated in the modeling phase. In this project, we build upon current work on a conceptual schema to represent clinical knowledge for decision support in the form of ifthen rules. This schema currently captures provenance of the clinical content, context where such content is actionable (i.e. constraints) and the logic of the rule itself. For this project, we borrowed concepts from both the Semantic Web (i.e., Ontologies) and Complex Adaptive Systems (CAS), to explore a conceptual approach for modeling rule interactions in an enterprise-wide clinical setting. We expect that a more comprehensive modeling will facilitate knowledge authoring, editing and update; foster consistency in rules implementation and maintenance; and develop authoritative knowledge repositories to promote quality, safety and efficacy of healthcare.
A Manual, Semi-Automated and Automated ROI Study of fMRI Hemodynamic Response
Authors: Zhang Jing  , Buchsbaum Monte S.  , Chu King-Wai  , Hazlett Erin A.
Published: February 2025

This study is a method comparison of three region-of-interest (ROI) tracing approaches. fMRI images acquired during an event-related frequency discrimination task were used in this study. Three [(1) manual, (2) semi-automated, (3) automated] approaches were applied to generate the ROI in the caudate nucleus and extract fMRI hemodynamic response (HR) from the ROI. Less activation with weak and delayed fMRI HR in the caudate were observed in patients than controls by the 3 approaches, but the manual and automated approaches were more sensitive in detecting such fMRI abnormalities. High correlations of the HR measures were found between the manual and semi-automated ROI approaches, suggesting that the semi-automated approach could be used as an alternative to the manual approach in detecting fMRI experimental effect.
Investigating the Efficacy of an Intelligent Operation Planning and Support Tool for Acute HealthCare Contexts
Authors: Wickramasinghe Nilmini  , Kent Bridie  , Moghimi Fatemeh Hoda  , Nguyen Lemai  , Redley Bernice  , Taylor Nyree  , Muhammed Imran  , Botti Mari
Published: February 2025

Nurses are the largest group of healthcare professionals in hospitals providing 24-hour care to patients. Hence, nurses are pivotal in coordinating and communicating patient care information in the complex network of healthcare professionals, services and other care processes. Yet, despite nurses' central role in health care delivery, intelligent systems have historically rarely been designed around nurses' operational needs. This could explain the poor integration of technologies into nursing work processes and consequent rejection by nursing professionals. The complex nature of acute care delivery in hospitals and the frequently interrupted patterns of nursing work suggest that nurses require flexible intelligent systems that can support and adapt to their variable workflow patterns. This study is designed to explore nurses' initial reactions to a new intelligent operational planning and support tool (IOPST) for acute healthcare. The following reports on the first stage of a longitudinal project to use an innovative approach involving nurses in the development of the IOPST; from conceptualization to implementation.
Managing Patients' Wait Time in Specialist Out-patient Clinic Using Real-time Data from Existing Queue Management and ADT Systems
Authors: Ju John Chen  , Gan Soon Ann  , Tan Siew Wee Justine  , Huang Yuchi Peter  , Mei Mei Chan  , Wong Mei Mei Sharon  , Fong Kam Weng
Published: February 2025

In major cancer centers, heavy patients load and multiple registration stations could cause significant wait time, and can be result in patient complains. Real-time patient journey data and visual display are useful tools in hospital patient queue management. This paper demonstrates how we capture patient queue data without deploying any tracing devices; and how to convert data into useful patient journey information to understand where interventions are likely to be most effective. During our system development, remarkable effort has been spent on resolving data discrepancy and balancing between accuracy and system performances. A web-based dashboard to display real-time information and a framework for data analysis were also developed to facilitate our clinics' operation. Result shows our system could eliminate more than 95% of data capturing errors and has improved patient wait time data accuracy since it was deployed.
Analysis of the Arrangement of Outpatient Units for Patients Receiving Multiple Consultations at a University Hospital
Authors: Suzuki Ryoji  , Takizawa Kiyomi  , Sakamaki Tetsuo
Published: February 2025

This study analyzed the arrangement (floor locations) of outpatient units for patients receiving multiple consultations. The Hospital Information System data from November 1, 2009 to September 30, 2012 of the Gunma University Hospital were used. The floor arrangements of the outpatient units were analyzed for outpatients who had received multiple consultations. A total of 168,193 outpatients who had received 1,260,307 consultations were included in the analysis. A total of 1,160,066(92.0%) outpatients had received 1 consultation, 93,763(7.4%) had received 2 consultations, and 6,478(0.6%) had received 3 or 4 consultations. Data from outpatients who had received 2 consultations were analyzed, and the data from the top 20 consultation combinations are shown. There were 12 different floor arrangements for outpatients undergoing 2 consultations. It is clear that outpatients who undergo multiple consultations must frequently move between different floors.