bluuebunny/crossref_metadata_2025 huggingface dataset:
Electronic Communication Experiences of Home Health Care Nurses and General Practitioners: a Cross-sectional Study
Authors: Lyngstad Merete  , Hellesø Ragnhild
Published: February 2025

Future health care will require suitable means of communication between home health care nurses and general practitioners (GPs) to ensure safe care for homebound patients. The overall aim of this study was to investigate the experiences of home health care nurses and general practitioners using e-messaging in their communication. We conducted a cross-sectional study with a mailed questionnaire. A total of 584 home health care nurses and GPs who used e-messaging and 495 home health care nurses and GPs who did not use e-messaging completed the questionnaire. The results showed that there was high agreement, in all the groups, that e-messaging led to better communication quality, better access to patient information, and an improved ability to prevent and reduce errors and omissions. Nurses reported the most agreement, which led to the conclusion that it was the characteristics of the profession rather than the use of e-messaging that influenced high agreement.
Qualitative Study of Patient Consent for Health Information Exchange in an HIV Clinic
Authors: Ramos S. Raquel  , Bakken Suzanne
Published: February 2025

Introduction/Background: Health information exchange (HIE) is the secure, electronic transfer and/or accessibility of clinical data among healthcare providers. In the United States (US), the consent process for participation varies state to state. New York State (NYS) mandates written patient consent. The purpose of this study was to examine workflow and perceptions related to obtaining HIE consent in an HIV clinic. Methods: We used contextual inquiry to observe the HIE consent-related workflow of four registration clerks for a total of 4 hours on two weekdays and subsequently created a flow chart and sequence model diagram. Clerks were also interviewed and the resulting narrative data were coded into themes. Results: Observational and interview data suggested that patient privacy/confidentiality/trust, high volume workflow, and multiple competing demands affect the patient HIE consent process. Conclusions: Additional qualitative data needs to be gathered from the perspectives of patients and clinicians about the HIE consent process.
A Decomposition Approach for Discovering Discriminative Motifs in a Sequence Database
Authors: Lesaint David  , Mehta Deepak  , O'Sullivan Barry  , Vigneron Vincent
Published: February 2025

This paper addresses the discovery of discriminative nary motifs in databases of labeled sequences. We consider databases made up of positive and negative sequences and define a motif as a set of patterns embedded in all positive sequences and subject to alignment constraints. We formulate constraints to eliminate redundant motifs and present a general constraint optimization framework to compute motifs that are exclusive to the positive sequences. We cast the discovery of closed and replication-free motifs in this framework and propose a two-stage approach whose last stage reduces to a minimum set covering problem. Experiments on protein sequence datasets demonstrate its efficiency.
Introducing Hierarchical Adversarial Search, a Scalable Search Procedure for Real-Time Strategy Games
Authors: Stanescu Marius  , Barriga Nicolas A.  , Buro Michael
Published: February 2025

Real-Time Strategy (RTS) video games have proven to be a very challenging application area for Artificial Intelligence research. Existing AI solutions are limited by vast state and action spaces and real-time constraints. Most implementations efficiently tackle various tactical or strategic sub-problems, but there is no single algorithm fast enough to be successfully applied to full RTS games. This paper introduces a hierarchical adversarial search framework which implements a different abstraction at each level — from deciding how to win the game at the top of the hierarchy to individual unit orders at the bottom.
Community Detection based on a Naming Game
Authors: Uzun Thaís Gobet  , Ribeiro Carlos Henrique Costa
Published: February 2025

Opinion exchange in a social network can profoundly affect its structure, given that agreeing with another person bounds he/she more closely and vice versa. In this work, we show that communication interactions can form and reveal the community structure of a network, as we present a new model where agents change their links and behaviors according to the local history of communication successes. Our simulations show that a local node parameter based on such history changes relatively to the node proportion of extra-community connections, and that (adaptive) edge weights tend to get high for intra-community and low for extra-community connections, also as a consequence of the history of communication successes. In non-convergent executions, the model gets trapped on a regime where clusters of agents agreeing with different words emerge, corresponding to the existing communities in the network.
Extending Semantic Sensor Networks for Automatically Tackling Smart Building Problems
Authors: Ploennigs Joern  , Schumann Anika  , Lecue Freddy
Published: February 2025

Sensor systems are constantly growing in all application areas and become elements of our environment. Semantic Sensor Networks (SSN) support this development and provide standardized semantic access for reasoning on this information. Unfortunately they do not model internal system knowledge or simple correlations between sensors and hence they cannot be used to automatically perform analytics tasks based on sensor data only. We show how SSN ontology can be extended and demonstrate its benefits for the task of diagnosing smart building problems using real-world data.
Towards Practical Deletion Repair of Inconsistent DL-programs
Authors: Eiter Thomas  , Fink Michael  , Stepanova Daria
Published: February 2025

Nonmonotonic Description Logic (DL-) programs couple nonmonotonic logic programs with DL-ontologies through queries in a loose way which may lead to inconsistency, i.e., lack of an answer set. Recently defined repair answer sets remedy this but a straightforward computation method lacks practicality. We present a novel evaluation algorithm for deletion repair answer sets based on support sets, which reduces evaluation of DL-LiteAontology queries to constraint matching. This leads to significant performance gains towards inconsistency management in practice.
Evolving Multi-Context Systems
Authors: Gonçalves Ricardo  , Knorr Matthias  , Leite João
Published: February 2025

Managed Multi-Context Systems (mMCSs) provide a general framework for integrating knowledge represented in heterogeneous KR formalisms. However, mMCSs are essentially static as they were not designed to run in a dynamic scenario. In this paper, we introduce evolving Multi-Context Systems (eMCSs), a general and flexible framework which inherits from mMCSs the ability to integrate knowledge represented in heterogeneous KR formalisms, and at the same time is able to both react to, and reason in the presence of commonly temporary dynamic observations, and evolve by incorporating new knowledge. We show that eMCSs are indeed very general and expressive enough to capture several existing KR approaches that model dynamics of knowledge.
An Agent-Based Model of Procrastination
Authors: Procee Ruurdje  , Kamphorst Bart A.  , van Wissen Arlette  , Meyer John-Jules
Published: February 2025

Procrastination is a widespread type of self-regulation failure that can have serious negative effects on people's health (e.g., because people delay or omit important health behaviors) and well-being. New “e-coaching” technologies make it possible in principle to offer tailored support to individuals in their efforts to change their self-undermining behavior. In practice, however, such automated support is currently unfeasible because the causal mechanisms behind procrastination are complex and poorly understood. This paper presents a new agent-based model of procrastination that integrates insights from economic models about the dynamics of procrastination with psychological concepts that can help explain the behavior on an individual level. The model is validated by using 5-fold cross validation with simulated annealing to fit and test the parameters on an existing dataset on academic procrastination (n=293). Results show that the agent displays realistic behavior and that the model with the fitted parameters performs significantly better (p<0.01) than the model with randomly selected parameters.
Human Speech Processing for Pedestrian Assistance: Towards Cognitive Error Handling in Spoken Dialogue Systems
Authors: Hacker Martin
Published: February 2025

Current spoken dialogue systems (SDS) often behave inappropriately as they do not feature the same capabilities to detect speech recognition errors and handle them adequately as is achieved in human conversation. Adopting human abilities to identify perception problems and strategies to recover from them would enable SDS to show more constructive and naturalistic behavior.
Computing Subjective Expected Utility using Probabilistic Description Logics
Authors: Acar Erman
Published: February 2025

We introduce a framework which is based on probabilistic Description logics (Prob-DL), to represent and solve multi-criteria discrete alternative problems by calculating expected utility. To our knowledge, this is the first ever approach for calculating expected utility using a Description logics based formalism.
Clause Simplifications in Search-Space Decomposition-Based Sat Solvers
Authors: Philipp Tobias
Published: February 2025

Inprocessing is to apply clause simplification techniques during search and is a very attractive idea since it allows to apply computationally expensive techniques. In this paper we present the search space decomposition formalism SSD that models parallel SAT solvers with clause sharing and inprocessing. The main result of this paper is that the sharing model SSD is sound. In the formalism, we combine clause addition and clause elimination techniques, and it covers many SAT solvers such as PaSAT, PaMira, PMSat, MiraXT and ccc. Inprocessing is not used in these solvers, and we therefore propose a novel way how to combine clause sharing, search space decomposition and inprocessing.
How to Measure Technology Assessment: an Introduction
Authors: Hasman Arie
Published: February 2025

This contribution introduces the Technology Acceptance model. Since information systems are still underutilized, application of models of user acceptance can provide important clues about what can be done to increase system usage.
Recognizing Questions and Answers in EMR Templates Using Natural Language Processing
Authors: Divita Guy  , Shen Shuying  , Carter Marjorie E.  , Redd Andrew  , Forbush Tyler  , Palmer Miland  , Samore Matthew H.  , Gundlapalli Adi V.
Published: February 2025

Templated boilerplate structures pose challenges to natural language processing (NLP) tools used for information extraction (IE). Routine error analyses while performing an IE task using Veterans Affairs (VA) medical records identified templates as an important cause of false positives. The baseline NLP pipeline (V3NLP) was adapted to recognize negation, questions and answers (QA) in various template types by adding a negation and slot:value identification annotator. The system was trained using a corpus of 975 documents developed as a reference standard for extracting psychosocial concepts. Iterative processing using the baseline tool and baseline+negation+QA revealed loss of numbers of concepts with a modest increase in true positives in several concept categories. Similar improvement was noted when the adapted V3NLP was used to process a random sample of 318,000 notes. We demonstrate the feasibility of adapting an NLP pipeline to recognize templates.
Assessing the Current State of Dental Informatics in Saudi Arabia: The New Frontier
Authors: Al-Nasser Lubna  , Al-Ehaideb Ali  , Househ Mowafa
Published: February 2025

Dental informatics is an emerging field that has the potential to transform the dental profession. This study aims to summarize the current applications of dental informatics in Saudi Arabia and to identify the challenges facing expansion of dental informatics in the Saudi context. Search for published articles and specialized forum entries was conducted, as well as interviews with dental professionals familiar with the topic. Results indicated that digital radiography/analysis and administrative management of dental practice are the commonest applications used. Applications in Saudi dental education included: web-based learning systems, computer-based assessments and virtual technology for clinical skills' teaching. Patients' education software, electronic dental/oral health records and the potential of dental research output from electronic databases are yet to be achieved in Saudi Arabia. Challenges facing Saudi dental informatics include: lack of IT infrastructure/support, social acceptability and financial cost. Several initiatives are taken towards the research in dental informatics. Still, more investments are needed to fully achieve the potential of various application of informatics in dental education, practice and research.
Emergency Department Waiting Times (EDWaT): A Patient Flow Management and Quality of Care Rating mHealth Application
Authors: Househ Mowafa  , Yunus Faisel
Published: February 2025

Saudi hospital emergency departments (ED) have suffered from long waiting times, which have led to a delay in emergency patient care. The increase in the population of Saudi Arabia is likely to further stretch the healthcare services due to overcrowding leading to decreased healthcare quality, long patient waits, patient dissatisfaction, ambulance diversions, decreased physician productivity, and increased frustration among medical staff. This will ultimately put patients at risk for poor health outcomes. Time is of the essence in emergencies and to get to an ED that has the shortest waiting time can mean life or death for a patient, especially in cases of stroke and myocardial infarction. In this paper, we present our work on the development of a mHealth Application – EDWaT – that will: provide patient flow information to the emergency medical services staff, help in quick routing of patients to the nearest hospital, and provide an opportunity for patients to review and rate the quality of care received at an ED, which will then be forwarded to ED services administrators. The quality ratings will help patients to choose between two EDs with the same waiting time and distance from their location. We anticipate that the use of EDWaT will help improve ED wait times and the quality of care provision in Saudi hospitals EDs.
Challenges in Building Health Surveillance Systems in Saudi Arabia
Authors: Al Saleem Nouf  , Househ Mowafa  , El Metwally Ashraf
Published: February 2025

This paper is aiming to briefly discuss the role of health surveillance system in strengthening public health at both the local and global level and the use of health informatics in effectively creating a database of health status for the population of Saudi Arabia. This review will specifically focus on the challenges that face the Kingdom of Saudi Arabia in order to effectively implement surveillance programs making use of advances in health information technology. Data collection was performed through a web-based retrieval of reports and articles and via an interview with an epidemiologist in the Saudi Ministry of Health Surveillance unit. Based on the results of this research, it was found that the use of technology has led to an improvement in communication between various stakeholders (e.g. clinicians, epidemiologists, and decision makers) by providing timely and accurate information needed for informed decision making. However, implementing an ideal model of surveillance systems in Saudi Arabia faces many challenges particularly in training healthcare providers to be qualified and competent enough to ensure the successful implementation of a disease surveillance system.
Machine Learning for Knowledge Extraction from PHR Big Data
Authors: Poulymenopoulou Michaela  , Malamateniou Flora  , Vassilacopoulos George
Published: February 2025

Cloud computing, Internet of things (IOT) and NoSQL database technologies can support a new generation of cloud-based PHR services that contain heterogeneous (unstructured, semi-structured and structured) patient data (health, social and lifestyle) from various sources, including automatically transmitted data from Internet connected devices of patient living space (e.g. medical devices connected to patients at home care). The patient data stored in such PHR systems constitute big data whose analysis with the use of appropriate machine learning algorithms is expected to improve diagnosis and treatment accuracy, to cut healthcare costs and, hence, to improve the overall quality and efficiency of healthcare provided. This paper describes a health data analytics engine which uses machine learning algorithms for analyzing cloud based PHR big health data towards knowledge extraction to support better healthcare delivery as regards disease diagnosis and prognosis. This engine comprises of the data preparation, the model generation and the data analysis modules and runs on the cloud taking advantage from the map/reduce paradigm provided by Apache Hadoop.
Evaluating a Health Educational First aid Program with the Implementation of Synchronous Distance Learning
Authors: Ponirou Paraskevi  , Diomidous Marianna  , Mantas John  , Kalokairinou Athena  , Kalouri Ourania  , Kapadochos Theodoros  , Tzavara Chara
Published: February 2025

The education in First Aid through health education programs can help in promoting the health of the population. Meanwhile, the development of alternative forms of education with emphasis on distance learning implemented with e-learning creates an innovative system of knowledge and skills in different population groups. The main purpose of this research proposal is to investigate the effectiveness of the educational program to candidates educators about knowledge and emergency preparedness at school. The study used the Solomon four group design (2 intervention groups and 2 control groups). Statistical analysis showed significant difference within the four groups. Intervention groups had improved significantly their knowledge showing that the program was effective and that they would eventually deal with a threatening situation with right handlings. There were no statistical significant findings regarding other independent variables (p>0,05).The health education program with the implementation of synchronous distance learning succeeded to enhance the knowledge of candidates educators.
Popularity of Russian Information Sources of Medical Education
Authors: Vasilyeva Irina V.  , Arseniev Sergey B.
Published: February 2025

The aim of the present study is to analyze the popularity of information sources of medical educational sites , medical information portal , medical portal for students <6years.net>, electronic library of medical literature ,  and . Three sites (,  and <6years.net>) provide sources of medical literature, educational videos, medical histories, medical papers and medical popular literature. And three other sites (,  and ) provide sources for electronic medical books on various subjects. Using on-line programs Alexa and Cy-pr we have analyzed the website's rating and identified the main data and time-varying data of the sites. Calculated Alexa Rank rating was determined for each site. Our study has shown that the most popular information sources of medical education among the six studied sites for Russian users is ; the site  is at the second place referring to the Alexa Rank rating and the site  is at the second place referring to the citation index in Yandex. The most popular medical site of electronic medical books is .
A virtual aged care system: When health informatics and spatial science intersect
Authors: Robertson Hamish  , Nicholas Nick  , Rosenfeld Tuly  , Georgiou Andrew  , Johnson Julie  , Travaglia Joanne
Published: February 2025

Healthcare systems are increasingly adapting to address the issues associated with population ageing. The shift to chronic diseases and a rise in neuroepidemiological conditions, associated with rising life expectancies, means that continued change and accommodation will be required of our health and social support systems. Current social policy environments developed out of early approaches to state-supported health and welfare service provision, most now a century or more old. A feature of these systems has often been a formal separation between them, into silos, that does not and cannot effectively address the issues raised by a growing population of older people. This is especially true in the context of community-based care where the majority of older people currently live and where governments hope to keep more elderly people living into the future. This objective will require a far more sophisticated and responsive approach to the health information environment than is currently the case. One strategy for improving this scenario is the development of augmented and virtual environments that collect and analyse real-time data on which health professionals and support staff can act in a timely manner. In this paper we explore some aspects of a virtualised aged care system and provide some examples of how this would enhance our current strategies for aged care.
Preliminary results from a study of the impact of digital activity trackers on health risk status
Authors: Rowe-Roberts Dinah  , Cercos Robert  , Mueller Florian ‘Floyd’
Published: February 2025

Digital activity trackers are becoming increasingly more widespread and affordable, providing new opportunities to support participatory e-health programs in which participants take an active role. However, there is limited knowledge of how to deploy these activity trackers within these programs. In response, we conducted a 7-month study with 212 employees using a wireless activity tracker to log step count. Our results suggest that these devices can support improving physical activity levels and consequently reduce diabetes risk factors. Furthermore, the intervention seems more effective for people with higher risk factors. With our work we aim to contribute to a better understanding of the issues and challenges involved in the design of participatory e-health programs that include activity trackers.
Pre-implementation investigation of the readiness of allied health professionals to adopt electronic health records
Authors: Hailey David  , Yu Ping  , Munyisia Esther
Published: February 2025

There has been limited uptake of electronic health records (EHR) by allied health professionals. Yet, not much attention has been given to their information needs. For EHR to work for these health professionals, it is essential to understand their current practice of information management and their perceptions towards EHR. A qualitative interview study was thus conducted with four managers in four allied health practices in Sydney to understand their perceptions for the adoption and use of a new Australian e-health standards compliant EHR system. We found that these allied health professionals were highly confident with the use of electronic information system and were enthusiastically expecting the introduction of the EHR system to support their information management and practice. A number of issues related to the use of EHR in practice for small, independent allied health practices were also discussed. It appears that allied health professionals today are information technology (IT) savvy and ready to adopt EHR. EHR for allied health practices in Australia are long overdue. The health informatics community can no longer ignore the need and want of allied health professionals for EHR that are tailored and built to support their information and practice management.
What is the effect of electronic pathology ordering on test re-ordering patterns for paediatric patients?
Authors: Li Ling  , Georgiou Andrew  , Vecellio Elia  , Eigenstetter Alex  , Toouli George  , Wilson Roger  , Westbrook Johanna I.
Published: February 2025

Electronic ordering systems have the potential to enhance the efficient utilisation of pathology services. The aim of this study was to assess the effect of electronic pathology ordering on repeat test ordering for paediatric patients (ages 0 to 18 years) who were in intensive care units (ICUs) and non-ICU wards. The dataset described 85,728 pathology tests ordered for 5,073 children before and after the implementation of electronic ordering. This study showed that, for children in ICUs, the repeat test order rate was significantly lower for electronic orders than for paper-based orders. Similarly, the rate of repeat tests ordered within short intervals (up to 23-hours), for children older than one-year in non-ICU wards, was lower for electronic ordering than for paper ordering. The proportion of repeat tests occurring within one-hour of the previous test was consistently lower for tests ordered using electronic ordering than it was for tests ordered using the paper based system for patients older than one-year in all wards and for patients under one-year in ICUs. These results suggest that features of the electronic system, including alerts about previously ordered tests and the availability of information about previous orders, can help clinicians to identify and reduce unnecessary repeat tests.
Recognition of health informatics in Australian standard classifications for research, occupation and education
Authors: Martin-Sanchez Fernando  , Gray Kathleen
Published: February 2025

Work on building a strong research base, a skilled workforce and an accredited learning and development system in Australian Health Informatics is not mature. This paper aims to explore how such work is supported at a fundamental level, that is, within formal systems for identifying fields of research, occupation and education in Australia. The researchers examined the treatment of Health Informatics and related terms in a range of relevant Australian standards. We found that Health Informatics has somewhat inappropriate recognition in the formal systems defining research in Australia, a tenuous presence in those describing education, and none in those describing occupations. We argue that our findings provide the evidence base for decisive action to benefit not only individuals but also the wider Australian community.
Development and evaluation of a memory clinic information system
Authors: Tapuria Archana  , Evans Matt  , Austin Tony  , Lea Nathan  , Kalra Dipak
Published: February 2025

Aim: To describe the requirements, development and evaluation of a cognitive disorders and older persons' clinical and research application, outlining the conceptual and practical challenges. Methods: A technology development methodology was used to develop a database of people being investigated for or diagnosed with cognitive disorders as well as their carers. The methodology involved phases of requirements gathering, modeling and prototype creation, and ‘bench testing’ the prototype with experts. Results: This case study suggests that construction and population of a memory clinic and research database is feasible, but initial development is complex. Its utility can be evaluated to some extent and was found to be acceptable to most users. Discussion and Conclusions: The development of a system needs to take in account existing data collection methods and other information systems used. The GreyMatters system can be considered a supplementary or complementary health record that sits alongside the main Trust information system. Integrating data from multiple systems enhances utility to clinical and research users.
Dengue Disease Outbreak Detection
Authors: Dayama Pankaj  , Sampath Kameshwaran
Published: February 2025

Early detection of outbreak of a disease may help in timely and effective public health interventions. Our motivation for this work is to assist EHD planning officer to analyze the incidence data and based on it declare whether there is an outbreak or not. In this paper, we develop ensemble of multiple techniques for detecting dengue disease outbreak. These techniques are applied to dengue incidence data from Singapore and results are summarized.
Two-dimensional Signal Analysis Reduced from Three-Dimensional Nystagmus Eye Movements
Authors: Juhola Martti  , Aalto Heikki  , Hirvonen Timo P.
Published: February 2025

Earlier we developed signal analysis for nystagmus measured from otoneurological patients suffering from vertigo and dizziness. It was based on three rotation directions of the eye: horizontal, vertical and torsional. However, nystagmus frequently appears only in two of the former directions. In order to enable two-dimensional analysis approach on the basis of various pairs from the original three, we designed and implemented an advanced method from our earlier one. These signals can be used to investigate and model the dysfunction of semicircular canals in the inner ear. Nystagmus has to be stimulated for healthy subjects, but in patients it can also be spontaneous. The method developed was tested with the signals of 30 otoneurological patients.
Analysis of Central Enterprise Architecture Elements in Models of Six eHealth Projects
Authors: Virkanen Hannu  , Mykkänen Juha
Published: February 2025

Large-scale initiatives for eHealth services have been established in many countries on regional or national level. The use of Enterprise Architecture has been suggested as a methodology to govern and support the initiation, specification and implementation of large-scale initiatives including the governance of business changes as well as information technology. This study reports an analysis of six health IT projects in relation to Enterprise Architecture elements, focusing on central EA elements and viewpoints in different projects.
EHR-based disease registries to support integrated care in a health neighbourhood: an ontology-based methodology
Authors: Liaw Siaw-Teng  , Taggart Jane  , Yu Hairong
Published: February 2025

Disease registries derived from Electronic Health Records (EHRs) are widely used for chronic disease management. We approached registries from the perspective of integrated care in a health neighbourhood, considering data quality issues such as semantic interoperability (consistency), accuracy, completeness and duplication. Our proposition is that a realist ontological approach is required to accurately identify patients in an EHR or data repository, assess data quality and fitness for use by the multidisciplinary integrated care team. We report on this approach with routinely collected data in a practice based research network in Australia.
Clinical Guideline-Driven Personalized Self-Management Diary for Paediatric Cancer Survivors
Authors: Stewart Samuel Alan  , Abidi Samina  , Parker Louise  , Bernstein Mark  , Abidi Syed Sibte Raza
Published: February 2025

Shared Decision Making (SDM) is the process of patients and clinicians working together to manage medical treatment using the existing knowledge base. This paper presents the YouCan framework, a system for summarizing and presenting the necessary knowledge for SDM related to pediatric cancer follow-up management. Knowledge modelling of a Clinical Practice Guideline produced a customized ontology, which was then passed through a pellet reasoned to produce a customized patient diary that summarizes a patient's oncological history as well as the potential issues they may face in follow-up.
Information Model for Learning Nursing Terminology
Authors: Nytun Jan Pettersen  , Fossum Mariann
Published: February 2025

Standardized terminologies are introduced in healthcare with the intention of improving information quality, which is important for enhancing the quality of healthcare itself. The International Classification for Nursing Practice (ICNP®) is a unified language system that presents an ontology for nursing terminology; it is meant for documentation of nursing diagnoses, nursing interventions and patient outcomes. This paper presents an information model and an application for teaching nursing students how to use ICNP to assist in the planning of nursing care. The model is an integration of ICNP and our catalog ontology, patient journal ontology, and ontology defining task sets. The application for learning nursing terminology offers descriptions of patient situations and then prompts the student to supply nursing statements for diagnoses, goals and interventions. The nursing statements may be selected from catalogues containing premade solutions based on ICNP, or they may be constructed directly by selecting terms from ICNP.
How are Electronic Medical Records Used by Nurse Practitioners?
Authors: Borycki Elizabeth M.  , Sangster-Gormley Esther  , Schreiber Rita  , Thompson Joanne  , Griffith Janessa  , Feddema April  , Kuo Alex
Published: February 2025

In this paper we describe how nurse practitioners (NPs) use electronic medical records (EMR) features and functions at: (1) an individual and (2) a clinic level to support patient wellness and chronic disease management activities. Fifteen NPs from British Columbia (BC), Canada participated in a qualitative, semi-structured interview study. NPs used EMRs with individual patients and at a clinic level to support wellness and chronic disease management activities. NP's used clinic notes, reminders, tasks and careplans to support wellness and disease management activities in individual patients while reports were used to manage patients at a clinic level.
Care Pathway Workbench: Evidence Harmonization from Guideline and Data
Authors: Yu Yiqin  , Liu Haifeng  , Li Jing  , Li Xiang  , Mei Jing  , Xie Guotong  , Perer Adam  , Wang Fei  , Hu Jianying
Published: February 2025

Care pathways (CPs) as a means of healthcare quality control are getting increasing attention due to widespread recognition in the healthcare industry of the need for well coordinated, evidence based and personalized care. To keep the promise, CPs require continuous refinement in order to stay up to date with regard to both clinical guidelines and data-driven insights from real world practices. There is therefore a strong demand for a unified platform that allows harmonization of evidence coming from multiple sources. In this paper we describe Care Pathway Workbench, a web-based platform that enables users to build and continuously improve Case Management Model and Notation based CPs by harmonizing evidences from guidelines and patient data. To illustrate the functionalities, we describe how a CHF (Congestive Heart Failure) Ambulatory Care Pathway can be developed using this workbench by first extracting key elements from widely accepted guidelines for CHF management, then incorporating evidence mined from clinical practice data, and finally transforming and exporting the resulting CP model to a care management product.
Knowledge Representations in Ambient Assisted Living – Context Awareness in Smart Homes
Authors: Zilm Franz-Albert  , Scharnweber Corinna  , Haux Reinhold
Published: February 2025

This paper introduces a knowledge representation for smart home rules and scenarios. We have created a rule base based on the rules found during a literature review. Following this, a general rule concept was derived from the identified categories. Furthermore, subcategories for certain contexts in the smart home environment were identified and illustrated in the results by means of an extract of the rules found in the literature. Based on this information, a hierarchically structured nomenclature with four axes has been developed and evaluated.
Using an Ontological Modeling to Evaluate the Consistency of Clinical Practice Guidelines: Application to the Comparison of Three Guidelines on the Management of Adult Hypertension
Authors: Galopin Alexandre  , Bouaud Jacques  , Pereira Suzanne  , Séroussi Brigitte
Published: February 2025

Every year, numerous clinical practice guidelines (CPGs) are published on a same topic. They may be conflicting, thus infringing clinicians' confidence in adhering to them. In order to build a clinical decision support system to assist GPs in the management of hypertension, we have considered three recent CPGs written in French. We developed a methodological framework to evaluate how consistent the three CPGs were. After a manual extraction of recommendation rules, all patient profiles covered by the CPGs have been identified. Then, ontological modeling and reasoning were used to build a subsumption graph of all profiles. This graph allows the retrieval of recommendations that could be conflicting. Results show that if rules are different in the three CPGs according to a document-based approach, many profiles are related through subsumption, and no critical inconsistencies were discovered when implementing an ontological modeling.
A Service Oriented Approach for Guidelines-based Clinical Decision Support using BPMN
Authors: Rodriguez-Loya Salvador  , Aziz Ayesha  , Chatwin Chris
Published: February 2025

Evidence-based medical practice requires that clinical guidelines need to be documented in such a way that they represent a clinical workflow in its most accessible form. In order to optimize clinical processes to improve clinical outcomes, we propose a Service Oriented Architecture (SOA) based approach for implementing clinical guidelines that can be accessed from an Electronic Health Record (EHR) application with a Web Services enabled communication mechanism with the Enterprise Service Bus. We have used Business Process Modelling Notation (BPMN) for modelling and presenting the clinical pathway in the form of a workflow. The aim of this study is to produce spontaneous alerts in the healthcare workflow in the diagnosis of Chronic Obstructive Pulmonary Disease (COPD). The use of BPMN as a tool to automate clinical guidelines has not been previously employed for providing Clinical Decision Support (CDS).
Alignment of High-Throughput Sequencing Data Inside In-Memory Databases
Authors: Firnkorn Daniel  , Knaup-Gregori Petra  , Lorenzo Bermejo Justo  , Ganzinger Matthias
Published: February 2025

In times of high-throughput DNA sequencing techniques, performance-capable analysis of DNA sequences is of high importance. Computer supported DNA analysis is still an intensive time-consuming task. In this paper we explore the potential of a new In-Memory database technology by using SAP's High Performance Analytic Appliance (HANA). We focus on read alignment as one of the first steps in DNA sequence analysis. In particular, we examined the widely used Burrows-Wheeler Aligner (BWA) and implemented stored procedures in both, HANA and the free database system MySQL, to compare execution time and memory management. To ensure that the results are comparable, MySQL has been running in memory as well, utilizing its integrated memory engine for database table creation. We implemented stored procedures, containing exact and inexact searching of DNA reads within the reference genome GRCh37. Due to technical restrictions in SAP HANA concerning recursion, the inexact matching problem could not be implemented on this platform. Hence, performance analysis between HANA and MySQL was made by comparing the execution time of the exact search procedures. Here, HANA was approximately 27 times faster than MySQL which means, that there is a high potential within the new In-Memory concepts, leading to further developments of DNA analysis procedures in the future.
Exploring the Application of Deep Learning Techniques on Medical Text Corpora
Authors: Minarro-Giménez José Antonio  , Marín-Alonso Oscar  , Samwald Matthias
Published: February 2025

With the rapidly growing amount of biomedical literature it becomes increasingly difficult to find relevant information quickly and reliably. In this study we applied the word2vec deep learning toolkit to medical corpora to test its potential for improving the accessibility of medical knowledge. We evaluated the efficiency of word2vec in identifying properties of pharmaceuticals based on mid-sized, unstructured medical text corpora without any additional background knowledge. Properties included relationships to diseases (‘may treat’) or physiological processes (‘has physiological effect’). We evaluated the relationships identified by word2vec through comparison with the National Drug File – Reference Terminology (NDF-RT) ontology. The results of our first evaluation were mixed, but helped us identify further avenues for employing deep learning technologies in medical information retrieval, as well as using them to complement curated knowledge captured in ontologies and taxonomies.
Beyond Copy and Paste: Clinician Approaches to Meeting Information Needs During Note Writing
Authors: Senathirajah Yalini  , Kaufman David  , Bakken Suzanne
Published: February 2025

Clinicians need historical information that does not change over time, as well as other information from the notes of others to inform their documentation – to save time, they cut and paste since that is a feature in many conventional EHRs. Copy and paste is a solution to clinicians' needs that has associated downsides including errors. As part of a study of clinicians using an innovative system which gives them complete control over information selection and arrangement, two used the process of note splitting to meet needs that are sometimes solved through cut and paste; four others used text insertion (partial note sections) to address related needs. The purpose of this study is to enhance understanding of the note splitting and text insertion phenomena by describing the processes, the resulting creations, and the associated clinician rationales. Mixed methods included a thinkaloud protocol and analysis of user interface creations and time sequences.
Enabling Person-Centric Care using Linked Data Technologies
Authors: Kotoulas Spyros  , Sedlazek Walter  , Lopez Vanessa  , Sbodio Marco  , Stephenson Martin  , Tommasi Pierpaolo  , Mac Aonghusa Pol
Published: February 2025

Patient-Centric Care requires comprehensive visibility into the strengths and vulnerabilities of individuals and populations. The systems involved in Patient-Centric Care are numerous and heterogeneous, span medical, behavioral and social domains and must be coordinated across government and NGO stakeholders in Health Care, Social Care and more. We present a system, based on Linked Data technologies, taking first steps in making this cross-domain information accessible and fit-for-use, using minimal structure and open vocabularies. We evaluate our system through user studies.
Nutritional Alert in hospitalized patients
Authors: Brieux Humberto Fernán Mandirola  , Kaminker Diego  , Campos Fernando  , Guillen Sebastian  , Alejandris Javier  , Luna Daniel  , Baum Analia  , de Quirós Fernán Gonzalez Bernaldo
Published: February 2025

The objective of the study is to assess a nutritional risk alert using an Informatics System in hospitalized patients versus the conventional methodology. Method: we studied 400 medical patients at the Belgrano Hospital Critical Care Unit. We considered two groups of 200 patients. In the first the group (Control Group), nutritional risk was diagnosed in a traditional way. In the second group (Alarm Group), nutritional risk was diagnosed with an alert system. The alert was triggered when a patient showed low levels of, at least, two of the following variables: albumin, cholesterol, triglyceride, lymphocyte or low body mass index (BMI). Results: nutritional risk was detected in 20.3% of the Control Group patients while, in the Alert Group, nutritional risk was detected in 34.3% of the patients; the difference between the two groups was significant (p<0.001), with a sensitivity rate of 99% and a specificity rate of 98%.Conclusion: malnutrition is more easily detected when using an alert system.
Abbreviations in Swedish Clinical Text – use by three professions
Authors: Lövestam Elin  , Velupillai Sumithra  , Kvist Maria
Published: February 2025

A list of 266 abbreviations from dieticians' notes in patient records was used to extract the same abbreviations from patient records written by three professions: dieticians, nurses and physicians. A context analysis of 40 of the abbreviations showed that ambiguous meanings were common. Abbreviations used by dieticians were found to be used by other professions, but not always with the same meaning. This ambiguity of abbreviations might cause misunderstandings and put patient safety at risk.
Secure Teleassistance towards endless medical litigations: Identification of liabilities through a protocol using Joint Watermarking-Encryption Evidences
Authors: Bouslimi D.  , Coatrieux G.  , Quantin C.  , Allaërt F.A.  , Cozic M.  , Roux Ch.
Published: February 2025

Teleassistance is defined by the help provided through a telemedicine network by a medical practitioner to one other medical practitioner faced to a difficult case. One of the main limiting factors of its development is the fear of the practitioners to be involved in a litigation. In such a situation, the main issue is to determine as quick and as certain as possible if the damage is in relation with the tort of negligence and the liabilities of each involved physician. After a brief summary of the legal context, we present a protocol combining joint watermarking-encryption and a third party to enforce exchange traceability and therefore to bring valuable electronic evidence in case of teleassistance litigations.
New Bachelors Degree Program in Health Informatics in Ethiopia: Curriculum Content and Development Approaches
Authors: Tilahun Binyam  , Zeleke Atinkut  , Fritz Fleur  , Zegeye Desalegn
Published: February 2025

With a widespread use of information technology in healthcare organizations, there is a pressing need for professionals who are both skilled in the use and management of information systems and knowledgeable in the field of healthcare. To fill this need, the department of health informatics at the University of Gondar started a new bachelor's degree in the health informatics program commencing in 2012. The curriculum was developed by a thorough needs assessment and considering the recommendations of the international medical informatics association. The program has duration of 4 years with a total of 249 ECTS. Currently there are 57 students enrolled in the program and 15 full time academic staffs are involved in the teaching and research activity of the department. To share our experience for other countries, in this paper we explain the curriculum development process and its content to the health informatics community.
Revisiting Heuristic Evaluation Methods to Improve the Reliability of Findings
Authors: Georgsson Mattias  , Weir Charlene R.  , Staggers Nancy
Published: February 2025

The heuristic evaluation (HE) method is one of the most common in the suite of tools for usability evaluations because it is a fast, inexpensive and resource-efficient process in relation to the many usability issues it generates. The method emphasizes completely independent initial expert evaluations. Inter-rater reliability and agreement coefficients are not calculated. The variability across evaluators, even dual domain experts, can be significant as is seen in the case study here. The implications of this wide variability mean that results are unique to each HE, results are not readily reproducible and HE research on usability is not yet creating a uniform body of knowledge. We offer recommendations to improve the science by incorporating selected techniques from qualitative research: calculating inter-rater reliability and agreement scores, creating a codebook to define concepts/categories and offering crucial information about raters' backgrounds, agreement techniques and the evaluation setting.
Determinants of continuance intention in a post-adoption satisfaction evaluation of a clinical information system
Authors: Hadji Brahim  , Dupuis Isabelle  , Leneveut Laurence  , Heudes Didier  , Wagner Jean-François  , Degoulet Patrice
Published: February 2025

: Purpose: The evaluation of end-user satisfaction is an essential part of any clinical information system (CIS) project. The purpose of this study is to evaluate the determinants of CIS continuance intention in a late post-adoption phase at the Georges Pompidou University Hospital (HEGP) in Paris.