bluuebunny/crossref_metadata_2025 huggingface dataset:
The Quality of Injury Data from Hospital Records in Vietnam
Authors: Hong Tran Thi , Walker Susan M , McKenzie Kirsten
Published: March 2016

The objective of this research was to examine the level of agreement of coders for ICD-10 coding of injury discharges in Danang General Hospital in Vietnam. Two hundred and five medical records of children hospitalised in this facility due to injury were randomly selected and recoded. Information from medical records abstracted by two trained staff was recoded by external coders in Hanoi and in Australia, using ICD-10. The completeness and detail of external cause of injury recorded in medical records was poor. Agreement between coders for injury coding was average, with 32% to 40% discrepancy in the main diagnosis codes at three character level, and 57% to 60% discrepancy at four character level, depending on which coders were being compared. It was concluded that as hospital data represent a cost-effective source of information regarding injuries, with significant costs incurred in collecting such information through special studies and censuses (especially for a developing country such as Vietnam), it is important to establish the quality and value of hospital data for injury surveillance and prevention research and to explore ways in which these data can be improved.
Do We Have Enough Information? How ICD-10-AM Activity Codes Measure UP
Authors: Soo Irene Hoi-Yen , Lam Mary K , Rust Julie , Madden Richard
Published: March 2016

This research explored the usage of activity codes introduced into the International Statistical Classification of Diseases and Related Health Problems, Tenth revision, Australian Modification (ICD-10-AM) Third Edition and examined the data quality of activity coding, explicitly, completeness and specificity. Injury separations for years 2001/02 to 2005/06 specifying a ‘true injury’ were extracted for descriptive analyses. Part A investigated the usage of activity codes and compared the usage of the 236 activity codes available in the Activity block (U50-U73) present in the ICD-10-AM Third Edition against the 16 codes present in the second edition. Part B examined the level of completeness of external cause coding and the degree of activity coding specificity in the 2005/06 dataset. It was found that the additional activity codes were used extensively with only 46 codes seldom assigned. Codes present in the second edition were extensively used in the third and fourth editions and the new additional activity codes represent 10% of all activity codes assigned per year. All five datasets demonstrated high levels of completeness, recording completeness levels greater than 97%, where missing activity codes attributed to the majority of missing codes. Fourteen out of the 24 activity categories demonstrated a strong reliance on non-specific codes and Team ball sports and Wheeled non-motor sports illustrated that activity codes assigned lacked detail in the code. Clinicians and coders need to acknowledge the importance of quality clinical documentation for research and policy-making purposes so that circumstances surrounding injury events can be coded to the highest level of specificity to improve injury prevention and control activities. Missing activity codes and the abundance of non-specific coding hinders the usefulness of the data.
Aspects of Coding in Canada: Through the Eyes of an Australian HIM
Authors: Bidie Alison
Published: March 2016

For the purpose of this brief update report, the author (an Australian Health Information Manager currently working in Canada) was asked to select certain aspects of the current coding system in Canada that she believes highlight relevant differences between the Canadian and Australian systems, on the assumption that this might be of interest to other Australian HIMs. The author has provided a brief overview of some recent changes to the Canadian classification system (e.g. new electronic product replacing coding books), as well a focus on some aspects of coder training and coding studies as seen through the eyes of an Australian HIM.
Professional Practice and Innovation: Users' Attitudes to an Electronic Medical Record System and its Correlates: A Multivariate Analysis
Authors: Al-Azmi Saadoun Faris , Al-Enezi Naser , Chowdhury Rafiq I
Published: March 2016

Implementation of an electronic medical record (EMR) system increases efficiency of health services, quality of care and patient satisfaction. Successful implementation depends on many factors, one of which is how users respond to the new system. We studied medical receptionists' appraisal of the newly implemented EMR system in primary healthcare centres in Kuwait. Four hundred receptionists were selected randomly from different healthcare centres and asked to complete a user interaction satisfaction questionnaire relating to their experience of the new system. The response rate was 80.5%. A large majority of the respondents considered the system to be flexible (83%), easy (89%), and satisfying (81%). However, more than one third of the respondents (36%) found the system inadequate. Bivariate and multivariate analyses found age, typing ability, ease of data entry and computer error as significant correlates with overall user response. These findings relating to users' reactions to various aspects of the EMR should assist policymakers to recognise the causes of dissatisfaction with the EMR among medical receptionists at health centre clinics that may adversely affect its successful implementation and regular use, as well as the quality of care provided by the clinics. In addition, the findings provide information to assist the development of guidelines for future implementation of the EMR system at the secondary healthcare level.
A World First in Cancer Data Collection Trial
Authors: Hopgood Nicole
Published: March 2016

An innovative study to collect comprehensive cancer data is underway in the Barwon Southwestern region of Victoria. The Evaluation of Cancer Outcomes (ECO) Trial involves the collection of a nationally developed and agreed set of clinical cancer data items across the region. Cancer is the leading cause of death in Australia and cancer surveillance relies heavily on accurate incidence and mortality data collection. The Victorian Government and Victorian Department of Human Services recently identified a lack of useful data surrounding patients diagnosed with cancer, their treatment, clinical course and outcomes. This article discusses the need for an improved and extended cancer data collection model and highlights the importance of timely population data on processes and outcomes of cancer.
Post eLetter Solutions: Healthy Results for Improving Patient Communication Processes at the Royal Hobart Hospital
Authors: Boulter Rhonda
Published: March 2016

The primary objective of the Australia Post eLetter project1 was to determine the feasibility of using the eLetter service with the Patient Administration System Appointment Scheduling Module to provide a fully automated mailing function that would eliminate the need for manual processing of mail delivery. Issues with timely delivery of letters throughout all outpatient sites at the Royal Hobart Hospital (RHH) have been identified as being mainly due to limited human resources being available to perform mailing duties and the like. This new desktop service enables staff to transmit data electronically in conjunction with the appointment software for large quantity mail postings to Australia Post via a secure line. Australia Post then validates the address, appends a barcode, prints the letter, envelopes it and inserts it into the mail distribution network in the state of the recipient. This article depicts the process that has eliminated the manual processing of a letter via the traditional Microsoft application, Wordmate, a system at RHH that was always difficult to use. With the introduction of eLetter, the RHH's Specialist Clinics have significantly improved the timeliness and quality of communication with patients as well as reducing administration tasks for staff.
ICT Applications as E-Health Solutions in Rural Healthcare in the Eastern Cape Province of South Africa
Authors: Ruxwana Nkqubela L , Herselman Marlien E , Conradie D Pieter
Published: March 2016

Information and Communication Technology (ICT) solutions (e.g. e-health, telemedicine, e-education) are often viewed as vehicles to bridge the digital divide between rural and urban healthcare centres and to resolve shortcomings in the rural health sector. This study focused on factors perceived to influence the uptake and use of ICTs as e-health solutions in selected rural Eastern Cape healthcare centres, and on structural variables relating to these facilities and processes. Attention was also given to two psychological variables that may underlie an individual's acceptance and use of ICTs: usefulness and ease of use. Recommendations are made with regard to how ICTs can be used more effectively to improve health systems at five rural healthcare centres where questionnaire and interview data were collected: St. Lucy's Hospital, Nessie Knight Hospital, the Tsilitwa Clinic, the Madzikane Ka-Zulu Memorial Hospital and the Nelson Mandela General Hospital.
Professional Practice and Innovation: The Development and Design of an Electronic Patient Record Using Open Source Web-Based Technology
Authors: Syed-Mohamad Sharifah Mastura , Ali Siti Hawa , Mat-Husin Mohd Nazri
Published: March 2016

This paper describes the method used to develop the One Stop Crisis Centre (OSCC) Portal, an open-source web-based electronic patient record system (EPR) for the One Stop Crisis Center, Hospital Universiti Sains Malaysia (HUSM) in Kelantan, Malaysia. Features and functionalities of the system are presented to demonstrate the workflow. Use of the OSCC Portal improved data integration and data communication and contributed to improvements in care management. With implementation of the OSCC portal, improved coordination between disciplines and standardisation of data in HUSM were noticed. It is expected that this will in turn result in improved data confidentiality and data integrity. The collected data will also be useful for quality assessment and research. Other low-resource centers with limited computer hardware and access to open-source software could benefit from this endeavour.
Translating Knowledge into Practice and Policy: The Role of Knowledge Networks in Primary Health Care
Authors: Armstrong Kylie , Kendall Elizabeth
Published: March 2016

The translation of information into practice is a well-recognised challenge for the health sector. In the primary healthcare sector, the last decade has seen an explosion of information generated by health systems, universities and a range of other sources. Without a system for translating that knowledge into practice and sharing it in a comprehensible form, it will remain meaningless to most practitioners. We propose the establishment of Knowledge Networks as a promising method for supporting the rapid adoption and generation of health information within the primary health care sector to advance health care services. These networks will be particularly important to the implementation of the national reform agenda, responsive decision-making and the translation of new frameworks or competencies into practice. This paper describes how interdisciplinary Knowledge Networks could be established focusing on a number of priority health research areas. Local Knowledge Networks would be used as a platform to support a collaborative web of evidence designed to influence health policy and planning. Our experience with Knowledge Networks indicates that they must be comprised of health professionals from Divisions of General Practice, researchers, policy-makers, consumers, government and non-government sectors. This paper will describe these networks and show how they might support the translation of knowledge into practice, thus driving systematic and institutional change.
Knowledge is Power: Transforming Rehabilitation Data into Information
Authors: Predl Nicolle
Published: March 2016

The Australian Health Service Alliance (AHSA) is a company that provides a number of services to more than 20 private health insurers, one of which is data management. AHSA prides itself on having excellent data and being able to provide it in an accurate, complete and timely manner, particularly Hospital Casemix Protocol (HCP), which is a combination of demographic and episode information, such as diagnosis and procedure codes, admission and separation dates. These data are used for analysis, benchmarking, negotiations (with private hospitals) and statutory reporting. However, AHSA had considerable data that could not be utilised effectively in the area of rehabilitation, due to the existence of a separate rehabilitation file (unlinked to the episode), and missing key information to describe the type of rehabilitation. This paper discusses the process put in place to transform data into useful and meaningful information, for analysis, benchmarking and payment model development.
Health Information Management Workforce — When Opportunities Abound
Authors: Bennett Vicki
Published: March 2016

Opportunity is missed by most people because it is dressed in overalls and looks like work. (Thomas Edison)
Professional Practice and Innovation: Level of Agreement between Coding Sources of Percentage Total Body Surface Area Burnt (%TBSA)
Authors: Watterson Dina , Cleland Heather , Picton Natalie , Simpson Pam M , Gabbe Belinda J
Published: March 2016

The percentage of total body surface area burnt (%TBSA) is a critical measure of burn injury severity and a key predictor of burn injury outcome. This study evaluated the level of agreement between four sources of %TBSA using 120 cases identified through the Victorian State Trauma Registry. Expert clinician, ICD-10-AM, Abbreviated Injury Scale, and burns registry coding were compared using measures of agreement. There was near-perfect agreement (weighted Kappa statistic 0.81–1) between all sources of data, suggesting that ICD-10-AM is a valid source of %TBSA and use of ICD-10-AM codes could reduce the resource used by trauma and burns registries capturing this information.
Professional Practice and Innovation: RF-MediSys: A Radio Frequency Identification-Based Electronic Medical Record System for Improving Medical Information Accessibility and Services at Point of Care
Authors: Ting Jacky S.L. , Tsang Albert H.C. , Ip Andrew W.H. , Ho George T.S.
Published: March 2016

This paper presents an innovative electronic medical records (EMR) system, RF-MediSys, which can perform medical information sharing and retrieval effectively and which is accessible via a ‘smart’ medical card. With such a system, medical diagnoses and treatment decisions can be significantly improved when compared with the conventional practice of using paper medical records systems. Furthermore, the entire healthcare delivery process, from registration to the dispensing or administration of medicines, can be visualised holistically to facilitate performance review. To examine the feasibility of implementing RF-MediSys and to determine its usefulness to users of the system, a survey was conducted within a multi-disciplinary medical service organisation that operates a network of medical clinics and paramedical service centres throughout Hong Kong Island, the Kowloon Peninsula and the New Territories. Questionnaires were distributed to 300 system users, including nurses, physicians and patients, to collect feedback on the operation and performance of RF-MediSys in comparison with conventional paper-based medical record systems. The response rate to the survey was 67%. Results showed a medium to high level of user satisfaction with the radiofrequency identification (RFID)-based EMR system. In particular, respondents provided high ratings on both ‘user-friendliness’ and ‘system performance’. Findings of the survey highlight the potential of RF-MediSys as a tool to enhance quality of medical services and patient safety.
Emerging Technologies: Web 2.0
Authors: Holt Claire
Published: March 2016

Web 2.0 has brought a change to how we communicate and disseminate information with the use of Twitter, Facebook, YouTube, instant messaging and blogging. This technology is beginning to be used in the health field for public awareness campaigns, emergency health alerts, medical education and remote healthcare services. Australian Health Information Managers will be called upon to reconcile their organisations' policies and procedures regarding the use of Web 2.0 technologies within the existing legal framework of privacy, confidentiality and consent. This article explores various applications of Web 2.0, their benefits and some of their potential legal and ethical implications when implemented in Australia.
Privacy, Employees and Human Resources: A Case Report
Authors: Mair Judith
Published: March 2016

Health practitioners are well versed in the need to maintain privacy and confidentiality of patients/clients in healthcare relationships. This need for confidentiality is likewise required when an employee of a healthcare institution becomes a patient of that institution. The question which arises is whether any information which emerges as a result of the employee also being a patient can or should be disclosed to the administration of the employing institution where such information may affect the employee or others in the workplace.
Consumer E-Health: An Overview of Research Evidence and Implications for Future Policy
Authors: Hordern Antonia , Georgiou Andrew , Whetton Sue , Prgomet Mirela
Published: March 2016

Consumer e-health is rapidly becoming a fundamental component of healthcare. However, to date only provisional steps have been taken to increase our understanding of how consumers engage with e-health. This study, an interpretive review, assessed the evidence about consumer use of e-health and identified five categories that encompass consumer e-health: (i) peer-to-peer online support groups; (ii) self-management/self-monitoring applications; (iii) decision aids; (iv) the personal health record; and (v) Internet use. Our findings reveal that e-health offers consumers many possibilities and potential benefits, although there appears to be apprehension concerning the efficacy of some interventions and barriers relating to the trustworthiness of Internet-acquired information. It is imperative that policy initiatives address these issues to ensure that consumer e-health services can be effectively, efficiently, and safely accessed.
Developing Policies for E-Health: Use of Online Health Information by Australian Health Professionals and Their Patients
Authors: Usher Wayne
Published: March 2016

An online survey ( www.limesurvey.org ) was used to identify patterns of usage of health information available on the Internet by five major Australian health professions (AHPs): general practice, social work, dietetics, physiotherapy and optometry. Survey questions were developed to explore participants' responses associated with their level of Internet usage. From the five AHPs ( n=746), it was found that social workers and dietitians most frequently recommended health websites to their patients (11–20% of the time throughout a 12-month period [2009]). Health information topics most frequently recommended and brought to health professionals' attention by patients were concerned with ‘specific health conditions’ and the main source professionals used to access health information was identified through the use of ‘search engines’. This study further reports that Internet recommendations from health professionals1 (1–10%), Internet requests from patients2 (<1%) and Internet consultation processes3 (1%), do not mirror similar international research. It is recommended that development of policies that might influence e-health should not be based on a presumption that the use of the Internet for accessing health information is universal or that the Internet strongly influences Australian healthcare delivery.
Does Attitude Matter in Computer Use in Australian General Practice? A Zero-Inflated Poisson Regression Analysis
Authors: Khan Asaduzzaman , Western Mark
Published: March 2016

The purpose of this study was to explore factors that facilitate or hinder effective use of computers in Australian general medical practice. This study is based on data extracted from a national telephone survey of 480 general practitioners (GPs) across Australia. Clinical functions performed by GPs using computers were examined using a zero-inflated Poisson (ZIP) regression modelling. About 17% of GPs were not using computer for any clinical function, while 18% reported using computers for all clinical functions. The ZIP model showed that computer anxiety was negatively associated with effective computer use, while practitioners' belief about usefulness of computers was positively associated with effective computer use. Being a female GP or working in partnership or group practice increased the odds of effectively using computers for clinical functions. To fully capitalise on the benefits of computer technology, GPs need to be convinced that this technology is useful and can make a difference.
How Good is New South Wales Admitted Patient Data Collection in Recording Births?
Authors: Lam Mary K
Published: March 2016

This record linkage study aims to examine the coding concordance of delivery outcome and discharge status between the New South Wales (NSW) Midwives Data Collection (MDC) and Admitted Patients Data Collection (APDC) as well as factors that contribute to hospital births not being recorded in the APDC. Births recorded in the APDC and MDC datasets for the calendar year 2005 were used for analysis. Births registered in the NSW Registry of Births Deaths and Marriages for the same period were used as validation. Descriptive analysis was used to examine coding concordance between the APDC and MDC datasets for matched records, and logistic regression analyses were used to identify factors associated with hospital births not being included in the APDC. A total of 90,585 unique births were recorded in the MDC for the calendar year 2005. A total of 79,173 confirmed hospital births were matched to corresponding records in the APDC; 2,249 (3%) confirmed hospital births were not found in the APDC. For unmatched records, logistic regression analyses showed that the level of obstetric hospital in which babies were born was a significant factor associated with information not being recorded in the APDC. As compared with local, small isolated, and small metropolitan hospitals (Levels 1 to 3 hospitals), larger tertiary hospitals (Levels 4 to 6) and private hospitals had decreased odds of hospital births not being recorded in the APDC. For matched records, 95% and 99% of records were found to be coded consistently between the APDC and MDC datasets for outcome of delivery and discharge status respectively. With a high level of coding concordance between the APDC and MDC datasets and only a small percentage of hospital births not being recorded in the APDC, the obstetrics subset of the APDC dataset was found to be of good quality.
Deploying Information Technology and Continuous Control Monitoring Systems in Hospitals to Prevent Medication Errors
Authors: Escobar-Rodríguez Tomás , Monge-Lozano Pedro , Romero-Alonso M. Mercedes , Bolívar-Raya M. Antonia
Published: March 2016

The serious repercussions of healthcare errors on patient safety have led hospitals to deploy information technology and continuous control monitoring systems to prevent them. Hospitals are moving away from traditional paper-based systems and focusing on designing new systems that prevent errors, using information technologies to catalyse the process re-engineering. This paper presents a case study that analyses the effect of computerised physician order entry and automated unit-based medication storage and distribution systems on the drug ordering and delivery process. It is concluded that information technology and continuous control monitoring systems have led to significant process re-engineering in the sequential stages of the drug ordering and delivery system. The new systems have also provided the opportunity to improve information available. This is an exploratory case study and the conclusions drawn from it offer possible routes for future research in this field.
Are General Practitioners Getting the Information They Need from Hospitals to Manage Their Lung Cancer Patients? A Qualitative Exploration
Authors: Rowlands Stella , Callen Joanne , Westbrook Johanna
Published: March 2016

The delivery of cancer services is primarily hospital-based; however, General Practitioners (GPs) have a key role to play within the context of a multidisciplinary model of care. In order to fulfill their role in cancer care GPs must receive complete and timely information from appropriate members of the hospital team. The aim of this study was to investigate perceptions of the quality, format and timeliness of the patient information GPs receive from a multidisciplinary hospital-based lung cancer team, and elicit how communication between the team and the GP could be improved. Data were collected using semi-structured interviews with a representative sample ( n=22) of members of the hospital team and a sample of GPs ( n=8). A grounded theory approach was used to categorise the data. Most communications with GPs were from medical officers; however, GPs desired information from all health professional groups in the hospital-based lung cancer team. Most GPs were dissatisfied with the timing of communication. A multidisciplinary discharge summary was suggested as a means of providing both clinical and social information from the team to the GP. Further developments in electronic health records could improve access to patient information by GPs. Results from this study illustrate the need for GPs to receive information from all members of the multidisciplinary hospital team so that they may fulfill their diverse role in supporting patients through all phases of the cancer journey.
Simulation Studies for the Evaluation of Health Information Technologies: Experiences and Results
Authors: Ammenwerth Elske , Hackl Werner O. , Binzer Kristine , Christoffersen Tue E. H. , Jensen Sanne , Lawton Kitta , Skjoet Peter , Nohr Christian
Published: March 2016

It is essential for new health information technologies (IT) to undergo rigorous evaluations to ensure they are effective and safe for use in real-world situations. However, evaluation of new health IT is challenging, as field studies are often not feasible when the technology being evaluated is not sufficiently mature. Laboratory-based evaluations have also been shown to have insufficient external validity. Simulation studies seem to be a way to bridge this gap. The aim of this study was to evaluate, using a simulation methodology, the impact of a new prototype of an electronic medication management system on the appropriateness of prescriptions and drug-related activities, including laboratory test ordering or medication changes. This article presents the results of a controlled simulation study with 50 simulation runs, including ten doctors and five simulation patients, and discusses experiences and lessons learnt while conducting the study. Although the new electronic medication management system showed tendencies to improve medication safety when compared with the standard system, this tendency was not significant. Altogether, five distinct situations were identified where the new medication management system did help to improve medication safety. This simulation study provided a good compromise between internal validity and external validity. However, several challenges need to be addressed when undertaking simulation evaluations including: preparation of adequate test cases; training of participants before using unfamiliar applications; consideration of time, effort and costs of conducting the simulation; technical maturity of the evaluated system; and allowing adequate preparation of simulation scenarios and simulation setting. Simulation studies are an interesting but time-consuming approach, which can be used to evaluate newly developed health IT systems, particularly those systems that are not yet sufficiently mature to undergo field evaluation studies.
Geocoding Coronial Data: Tools and Techniques to Improve Data Quality
Authors: Freestone Darren , Williamson Dianne , Wollersheim Dennis
Published: March 2016

Clinical, administrative and demographic health information is fundamental to understanding the nature of health and evaluating the effectiveness of efforts to reduce morbidity and mortality of the population. The demographic data item ‘location’ is an integral part of any injury surveillance tool or injury prevention strategy. The true value of location data can only be realised once these data have been appropriately classified and quality assured. Geocoding as a means of classifying location is increasingly used in various health fields to enable spatial analysis of data. This article reports on research carried out in Australia at the National Coroners Information System (NCIS). Trends in the use of NCIS location-based data by researchers were identified. The research also aimed to establish the factors that impacted on the quality of geocoded data and the extent of this impact. A systematic analysis of the geocoding process identified source documentation, data cleaning, and software settings as key factors impacting on data quality. Understanding and application of these processes can improve data quality and therefore inform the analysis and interpretation of these data by researchers.
Service Quality and Perceived Value of Technology-Based Service Encounters: Evaluation of Clinical Staff Satisfaction in Taiwan
Authors: Hung Chung-Jye , Chang Hsin Hsin , Eng Cheng Joo , Wong Kit Hong
Published: March 2016

Previous research has evaluated technology-based service encounters (TBSEs) in the delivery of health care by assessing patient satisfaction. This study examined service quality and perceived value of TBSES used in health organisations from the perspective of clinical staff, with staff technology readiness as a moderator. A quantitative survey was conducted in Taiwan, across private and public healthcare organisations. Results showed that TBSEs had a direct effect on service quality and perceived value, which in turn had a direct effect on staff satisfaction in using TBSES. However, service quality had no effect on perceived value when moderated by technology readiness. Theoretical and managerial implications of these findings are discussed.
Methodological Processes in Validating and Analysing the Quality of Population-Based Data: A Case Study Using the Victorian Perinatal Data Collection
Authors: Davey Mary-Ann , Sloan Mary-Louise , Palma Sonia , Riley Merilyn , King James
Published: March 2016

This paper describes methods used and results obtained from a study that measured the accuracy of a routinely collected population-based data set. Data on a random sample of births were extracted from the 2003 Victorian Perinatal Data Collection (VPDC) and compared with information in the original medical record. Accuracy was calculated for 111 items related to diverse aspects of maternity and neonatal health and care. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for dichotomous items. Seventy-nine items were accurate in at least 97% of cases, 45 of them in at least 99% of cases, and accuracy was below 90% for five items. Very high specificities demonstrate that conditions were rarely reported in error. Lower sensitivities indicate that some events that occurred went unreported on the perinatal form. The excellent results for specificity indicated that the dataset is appropriate for a conservative analysis of relationships between factors. The lower sensitivities could result in true relationships between factors remaining unidentified. Reasons for discrepancies between the VPDC and the original medical record are described.
A Process Mining-Based Investigation of Adverse Events in Care Processes
Authors: Caron Filip , Vanthienen Jan , Vanhaecht Kris , Van Limbergen Erik , Deweerdt Jochen , Baesens Bart
Published: March 2016

This paper proposes the Clinical Pathway Analysis Method (CPAM) approach that enables the extraction of valuable organisational and medical information on past clinical pathway executions from the event logs of healthcare information systems. The method deals with the complexity of real-World clinical pathways by introducing a perspective-based segmentation of the date-stamped event log. CPAM enables the clinical pathway analyst to effectively and efficiently acquire a profound insight into the clinical pathways. By comparing the specific medical conditions of patients with the factors used for characterising the different clinical pathway variants, the medical expert can identify the best therapeutic option. Process mining-based analytics enables the acquisition of valuable insights into clinical pathways, based on the complete audit traces of previous clinical pathway instances. Additionally, the methodology is suited to assess guideline compliance and analyse adverse events. Finally, the methodology provides support for eliciting tacit knowledge and providing treatment selection assistance.
Web-Based Geo-Visualisation of Spatial Information to Support Evidence-Based Health Policy: A Case Study of the Development Process of Health Tracks
Authors: Jardine Andrew , Mullan Narelle , Gudes Ori , Cosford James , Moncrieff Simon , West Geoff , Xiao Jianguo , Yun Grace , Somerford Peter
Published: March 2016

Place is of critical importance to health as it can reveal patterns of disease spread and clustering, associations with risk factors, and areas with greatest need for, or least access to healthcare services and promotion activities. Furthermore, in order to get a good understanding of the health status and needs of a particular area a broad range of data are required which can often be difficult and time consuming to obtain and collate. This process has been expedited by bringing together multiple data sources and making them available in an online geo-visualisation, HealthTracks, which consists of a mapping and reporting component. The overall aim of the HealthTracks project is to make spatial health information more accessible to policymakers, analysts, planners and program managers to inform decision-making across the Department of Health western Australia. Preliminary mapping and reporting applications that have been utilised to inform service planning, increased awareness of the utility of spatial information and improved efficiency in data access were developed. The future for HealthTracks involves expanding the range of data available and developing new analytical capabilities in order to work towards providing external agencies, researchers and eventually the general public access to rich local area spatial data.
Improving Performance and Agreement in Injury Coding Using the Abbreviated Injury Scale: A Training Course Helps
Authors: Joosse Pieter , de Jongh Mariska A.C. , van Delft-Schreurs C.C.H.M. (Katinka) , Verhofstad Michiel H.J. , Goslings J Carel
Published: March 2016

The aim of this study was to determine the influence of a dedicated training course on the ability of participants to assign correct codes and their inter-observer agreement using the Abbreviated Injury Scale (AIS98). Twelve participants followed a one-day training course in injury coding. Codes were recorded before, during and after the course. The number of correctly assigned codes and severity codes, as well as the Fleiss' kappas improved significantly during and after the course. This study emphasises the benefit of training in injury coding. Training improves the ability to assign correct codes and it reduces inter-observer variability. We advise all who are involved in injury coding to follow a dedicated training course.
Impact of Documentation Errors on Accuracy of Cause of Death Coding in an Educational Hospital in Southern Iran
Authors: Haghighi Mohammad Hosein Hayavi , Dehghani Mohammad , Teshizi Saeid Hoseini , Mahmoodi Hamid
Published: March 2016

Accurate cause of death coding leads to organised and usable death information but there are some factors that influence documentation on death certificates and therefore affect the coding. We reviewed the role of documentation errors on the accuracy of death coding at Shahid Mohammadi Hospital (SMH), Bandar Abbas, Iran. We studied the death certificates of all deceased patients in SMH from October 2010 to March 2011. Researchers determined and coded the underlying cause of death on the death certificates according to the guidelines issued by the World Health Organization in Volume 2 of the International Statistical Classification of Diseases and Health Related Problems-10th revision (ICD-10). Necessary ICD coding rules (such as the General Principle, Rules 1–3, the modification rules and other instructions about death coding) were applied to select the underlying cause of death on each certificate. Demographic details and documentation errors were then extracted. Data were analysed with descriptive statistics and chi square tests. The accuracy rate of causes of death coding was 51.7%, demonstrating a statistically significant relationship (p=.001) with major errors but not such a relationship with minor errors. Factors that result in poor quality of Cause of Death coding in SMH are lack of coder training, documentation errors and the undesirable structure of death certificates.
Speech Recognition in the Radiology Department: A Systematic Review
Authors: Hammana Imane , Lepanto Luigi , Poder Thomas , Bellemare Christian , Ly My-Sandra
Published: March 2016

Objective:

to conduct a systematic review of the literature describing the impact of speech recognition systems on report error rates and productivity in radiology departments.

Methods:

The search was conducted for relevant papers published from January 1992 to October 2013. Comparative studies reporting any of the following outcomes were selected: error rates, departmental productivity, and radiologist productivity. The retrieved studies were assessed for quality and risk of bias.

Results:

The literature search identified 85 potentially relevant publications, but, based on the inclusion and exclusion criteria, only 20 were included. Most studies were before and after assessments with no control group. There was a large amount of heterogeneity due to differences in the imaging modalities assessed and the outcomes measured. The percentage of reports containing at least one error varied from 4.8% to 89% for speech recognition, and from 2.1% to 22% for transcription. Departmental productivity was improved with decreases in report turnaround times varying from 35% to 99%. Most studies found a lengthening of radiologist dictation time.

Conclusion:

Overall gains in departmental productivity were high, but radiologist productivity, as measured by the time to produce a report, was diminished.
The Role of Information and Communication Technology in the Transformation of the Healthcare Business Model: A Case Study of Slovenia
Authors: Stanimirovic Dalibor , Vintar Mirko
Published: March 2016

Background:

The Slovenian healthcare business model (BM) has largely failed to integrate information and communication technologies (ICT) into its operational context, instead maintaining its rigid structure and traditional ‘way of doing business’. This situation often results in uncoordinated business operations, while additionally destabilising an already underfinanced healthcare system and compromising the general quality of healthcare.

Aim:

The aim of this study is to provide an analysis of the BM concept and its implications, and to identify the potential effects of informatisation on the existing healthcare BM in Slovenia. Based on the findings, the paper concludes by presenting a conceptualisation of a transformed healthcare BM adapted to the Slovenian healthcare environment.

Method:

The study employs a single explanatory/exploratory case study design, while the validation of the hypothesised constructs was undertaken through structured interviews with twelve prominent experts from the Slovenian healthcare system. Interviewees were: healthcare professionals (two general practitioners and two specialists), ICT experts from healthcare (one ICT consultant and three analysts), and healthcare managers (two managers of public healthcare centres and two managers of public clinics).

Results:

Findings present a roadmap for the redefinition of BM elements and the transformation of the Slovenian healthcare BM. It includes the specific reconfiguration of BM actors and their interactions, and the application of advanced ICT solutions, which could facilitate more effective utilisation of healthcare resources and promote an improved delivery of healthcare services and products.

Conclusion:

The presented development approach and derived conceptual solution could be transferable to other countries with similar socio-economic characteristics and comparable healthcare systems, subject to certain adjustments and inclusion of national specifics.
Standing Your Ground: The Importance of Health Information Managers Sharing What They Do
Authors: Henderson Joan
Published: March 2016

Health information management professionals have a broad range of skills that are invaluable to the health sector. The advent of the electronic health record has provided the opportunity to aggregate patient data to answer clinical and policy questions in a systematic, timely and reproducible way. The possibility of linking datasets provides greater opportunities for answering clinical and policy questions, and Health Information Managers (HIMs) have the best skill set to inform about data quality, coding and classification, privacy, security, and medicolegal implications involved in the ethical handling of such datasets. HIMs have access to a wealth of data that could improve patient care and reduce unnecessary service utilisation, and that could be used to answer many research questions. Undertaking and publishing research is an excellent avenue for HIMs to promote and strengthen their profession.
Data Quality Associated with Handwritten Laboratory Test Requests: Classification and Frequency of Data-Entry Errors for Outpatient Serology Tests
Authors: Vecellio Elia , Maley Michael W. , Toouli George , Georgiou Andrew , Westbrook Johanna
Published: March 2016

Objective:

Manual data-entry of handwritten laboratory test requests into electronic information systems has implications for data accuracy. This study sought to identify the types and number of errors occurring for handwritten serology test requests received from outpatient clinics.

Methods:

A 15-day audit at a serology laboratory in Sydney, Australia, compared the content of all transcribed serology outpatient test requests in the laboratory information system with the handwritten request form.

Results:

One or more errors were detected in 67/627 (10.7%) audited requests ( N=68 errors). Fifty-one of the errors (75.0%) were transcription errors: the wrong test was transcribed in 40/68 cases (58.8%) – ten of these occurred when the abbreviations ‘HBsAb’ and ‘HBsAg’ were confounded for one another – and transcribed requests were missing a test in 11/68 cases (16.2%). The remaining 17 non-transcription errors (25.0%) described request forms not signed by the ordering clinician, mislabelled specimens, and wrong tests due to computer algorithm errors.

Conclusions:

Manual data-entry of handwritten serology requests is an error-prone process. Electronic ordering has the potential to eliminate illegible handwriting and transcription errors, thus improving data accuracy in hospital information systems.
“Muslimness” and multiplicity in qualitative research and in government reports in Canada
Authors: Selby Jennifer A
Published: March 2016

With reference to a qualitative study on everyday religiosity among Muslims in St. John's, Canada, this paper examines trends in academic sources and public policy on Islam that over-privilege the most committed practitioners, thereby narrowly depicting “Muslimness.” I situate this overemphasis by reflecting on what Mamdani calls “culture talk,” an essentializing discourse heightened in the post-9/11 west (c.f. Shryock on “Islamophilia”). Interview data, along with a trend in social scientific research on Muslims that emphasize the most pious and the outcomes following the Ontario “Boyd Report” and the Quebecois “Bouchard–Taylor Report” show the pervasiveness of culture talk that erases Muslim multiplicity.
Judging Expertise
Authors: O’Brien Timothy L.
Published: March 2016

This article develops a framework for understanding the role of gender in negotiations of expert authority and tests the new approach with an analysis of legal disputes about expert witness credibility ( N = 435). Content-coded data from patent infringement, civil rights, and medical malpractice lawsuits in U.S. district courts indicate that lawyers’ challenges to expert witnesses’ credibility reflect widely held cultural beliefs about gender and certain kinds of expertise: whereas women are more likely than men to be challenged as unqualified to testify, men are more likely than women to be contested as irrelevant to the case. Furthermore, although highly credentialed women and men have equal chances of overcoming credibility challenges, women with fewer credentials are substantially more likely than men to be excluded from court. Overall, findings suggest that women must clear a higher bar than men to demonstrate their credibility as expert witnesses. Moreover, this study indicates that disputes about expert witness credibility are a site where stereotypes about gender and expertise are reproduced in the justice system.
An autonomous CEBPA enhancer specific for myeloid-lineage priming and neutrophilic differentiation
Authors: Avellino Roberto , Havermans Marije , Erpelinck Claudia , Sanders Mathijs A. , Hoogenboezem Remco , van de Werken Harmen J. G. , Rombouts Elwin , van Lom Kirsten , van Strien Paulina M. H. , Gebhard Claudia , Rehli Michael , Pimanda John , Beck Dominik , Erkeland Stefan , Kuiken Thijs , de Looper Hans , Gröschel Stefan , Touw Ivo , Bindels Eric , Delwel Ruud
Published: March 2016

Key Points

The CEBPA locus harbors 14 enhancers of which distinct combinations are active in different CEBPA-expressing tissues. A +42-kb enhancer is required for myeloid-lineage priming to drive adequate CEBPA expression levels necessary for neutrophilic maturation.
How can the audiogram be more useful?
Authors: Harrison Robert V
Published: March 2016

The Canadian Hearing and Auditory Research Translation (CHART) group is a newly formed taskforce to develop collaborative research initiatives. Initial discussions centered on diagnostic improvements for middle ear disease, auditory neuropathy spectrum disorder, tinnitus and presbycusis. Central to these discussions was the widely held view that the standard audiogram and its interpretation is inadequate to for describing many forms of hearing problems that we now recognize. This letter is designed to create awareness and to seek feedback from hearing healthcare professionals on their experience regarding the adequacy (or otherwise) of the audiogram in its present form.