bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving Patients Experience in Peadiatric Emergency Waiting Room
Authors: Ehrler Frederic  , Siebert Johan  , Wipfli Rolf  , Duret Cyrille  , Gervaix Alain  , Lovis Christian
Published: February 2025

When visiting the emergency department, the perception of the time spent in the waiting room before the beginning of the care, may influence patients' experience. Based on models of service evaluation, highlighting the importance of informing people about their waiting process and their place in the queue, we have developed an innovative information screen aiming at improving perception of time by patients. Following an iterative process, a group of experts including computer scientists, ergonomists and caregivers designed a solution adapted to the pediatric context. The solution includes a screen displaying five lanes representing triage levels. Patients are represented by individual avatars, drawn sequentially in the appropriate line. The interface has been designed using gamification principle, aiming at increasing acceptance, lowering learning curve and improving satisfaction. Questionnaire based evaluation results revealed high satisfaction from the 278 respondents even if the informative content was not always completely clear.
Capturing Provenance, Evolution and Modification of Clinical Protocols via a Heterogeneous, Semantic Social Network
Authors: Portokallidis Nick  , Drosatos George  , Kaldoudi Eleni
Published: February 2025

Healthcare delivery is largely based on medical best practices as in clinical protocols. Research so far has addressed the computerized execution of clinical protocols by developing a number of related representation languages, execution engines and integrated platforms to support real time execution. However, much less effort has been put into organizing clinical protocols for use and reuse. In this paper we propose a heterogeneous semantic social network to describe and organize clinical protocols based on their provenance, evolution and modifications. The proposed approach allows semantic tagging and enrichment of clinical protocols so that they can be used and re-used across platforms and also be linked directly to other relevant scientific information, e.g. published works in PubMed or personal health records, and other clinical information systems.
Biometric Attendance and Big Data Analysis for Optimizing Work Processes
Authors: Verma Neetu  , Xavier Teenu  , Agrawal Deepak
Published: February 2025

Although biometric attendance management is available, large healthcare organizations have difficulty in big data analysis for optimization of work processes. The aim of this project was to assess the implementation of a biometric attendance system and its utility following big data analysis. In this prospective study the implementation of biometric system was evaluated over 3 month period at our institution. Software integration with other existing systems for data analysis was also evaluated. Implementation of the biometric system could be successfully done over a two month period with enrollment of 10,000 employees into the system. However generating reports and taking action this large number of staff was a challenge. For this purpose software was made for capturing the duty roster of each employee and integrating it with the biometric system and adding an SMS gateway. This helped in automating the process of sending SMSs to each employee who had not signed in. Standalone biometric systems have limited functionality in large organizations unless it is meshed with employee duty roster.
Accelerating the Global Workforce Demand for Nurse Informaticians: Advanced Health Informatics Certification (AHIC)
Authors: Gadd Cynthia  , Delaney Connie W.  , de Fátima Marin Heimar  , Greenwood Karen  , Williamson Jeffrey J.
Published: February 2025

Advances in professional recognition of nursing informatics vary by country but examples exist of training programs moving from curriculum-based education to competency based frameworks to produce highly skilled nursing informaticians. This panel will discuss a significant credentialing project in the United States that should further enhance professional recognition of highly skilled nurses matriculating from NI programs as well as nurses functioning in positions where informatics-induced transformation is occurring. The panel will discuss the professionalization of health informatics by describing core content, training requirements, education needs, and administrative framework applicable for the creation of an Advanced Health Informatics Certification (AHIC).
MonDossierMedical.ch – The Personal Health Record for Every Geneva Citizen
Authors: Rosemberg Aurélie  , Schmid Adian  , Plaut Olivier
Published: February 2025

MonDossierMedical.ch is a project led by the canton of Geneva, making it possible for every patient to access his own electronic health record (EHR) and to share the medical files with his doctors. It was introduced across the canton in mid-2013, and provided to all patients free of charge. It is based on the first Swiss-wide eHealth-compliant pilot project “e-toile”. The canton of Geneva developed “e-toile” as a public-private partnership together with Swiss Post and it was launched in 2011 in some of the canton's municipalities. Back then, Geneva's EHR represented the first Swiss attempt to link all healthcare professionals in the treatment chain. Today, it serves more than 6,000 patients and 400 physicians. This number is growing regularly, as well as the health care institutions (private hospitals, labs) joining the community. The project fits into the national strategy of Switzerland in establishing a national EHR by linking regional implementations like MonDossierMedical.
Design of an Electronic Reminder System for Supporting the Integerity of Nursing Records
Authors: Chen Chien-Min  , Hou I-Ching  , Chen Hsiao-Ping  , Weng Yung-Ching
Published: February 2025

The integrity of electronic nursing records (ENRs) stands for the quality of medical records. But patients' conditions are varied (e.g. not every patient had wound or need fall prevention), to achieve the integrity of ENRs depends much on clinical nurses' attention. Our study site, an one 2,300-bed hospital in northern Taiwan, there are a total of 20 ENRs including nursing assessments, nursing care plan, discharge planning etc. implemented in the whole hospital before 2014. It become important to help clinical nurses to decrease their human recall burden to complete these records. Thus, the purpose of this study was to design an ENRs reminder system (NRS) to facilitate nursing recording process. The research team consisted of an ENR engineer, a clinical head nurse and a nursing informatics specialist began to investigate NRS through three phases (e.g. information requirements; design and implementation). In early 2014, a qualitative research method was used to identify NRS information requirements through both groups (e.g. clinical nurses and their head nurses) focus interviews. According to the their requirements, one prototype was created by the nursing informatics specialist. Then the engineer used Microsoft Visual Studio 2012, C#, and Oracle to designed a web-based NRS (Figure 1). Then the integrity reminder system which including a total of twelve electronic nursing records was designed and the preliminary accuracy validation of the system was 100%. NRS could be used to support nursing recording process and prepared for implementing in the following phase.
Improving EHR Usability Using LEAN Methodology
Authors: Bosse Corbin  , Kelly Kandace
Published: February 2025

Electronic health record (EHR) usability concerns continue to reduce EHR effectiveness. LEAN methodology, which focuses on waste elimination, may provide an effective method to address efficiency related usability deficiencies. We aimed to improve the usability of an inpatient seclusion and restraint (SR) EHR module using LEAN methodology. A multidisciplinary team convened to evaluate and redesign clinical and technological SR workflows using LEAN techniques, including process mapping and time-series analyses. SR module modifications addressed 40 of the 60 efficiency related usability deficiencies identified in the initial SR module. Usability enhancements included elimination of 10 nonessential inputs, 21 redundancies, and nine overhead functions. Process steps were reduced from 74 to 47. Improving EHR usability is critical to assure safe, effective, and efficient care1. We demonstrated that LEAN methodology is an effective method to address efficiency related EHR usability deficiencies. More research is needed to determine how these improvements impact care quality.
Utilization of Communication Robot in Patient Education
Authors: Ishiguro Keitaro  , Majima Yukie
Published: February 2025

In Japan, the population is expected to decrease. Moreover, the proportion of elderly people living alone among the elderly population is expected to increase for both men and women. Therefore, the demand for elderly care is increasing year by year. In this paper, we aim at making environment in which elderly people can receive interactive guidance, and reducing the burden on medical staff such as caregivers and nurses. So, we design a patient education by ARCS model which classifies concepts related to learning motivation, and consider to utilize a communication robot “Pepper”.
Relationship Between Organizational Culture and Organizational Effectiveness – A Study of Nurses in Taiwan
Authors: Yan Yu-Hua
Published: February 2025

Organizational culture refers to the beliefs and values that have existed in an organization for a long time, and to the beliefs of the staff and the foreseen value of their work that will influence their attitudes and behavior. It is therefore essential to understand the relationship between organizational cultures and organizational effectiveness.
An Assessment of the Application of Pharma Cloud System to the National Health Insurance Program of Taiwan and the Result in Hospitals
Authors: Yan Yu-Hua  , Lu Chen-Luan
Published: February 2025

National Health Insurance Administration established Pharma Cloud System in July 2014. The purpose is to decrease therapeutic duplications and enhance public medication safety. Comparison will be made among individual hospitals and the administering branches of National Health Insurance Bureau (NHIB) on the statistical data on the inquiry of the cloud medication history record system to understand the result of the installation and advocacy of this system. The results show (1) there were 2,329,846 entries of data collected from the branches of the NHIB from 2015 on cloud medication history record and 50,224 entries of data from individual hospitals. (2) The inquiry rate at the branches of the NHIB was 43.2% from January to April, 2015 and at individual hospitals was 18.8%. (3) The improvement rate at the branches of the NHIB was 32.5% and at the individual hospitals was 47.0% from January to April, 2015.
Social Media and Population Health Virtual Exchange for Senior Nursing Students: An International Collaboration
Authors: Procter Paula M.  , Brixey Juliana J.  , Honey Michelle L.L.  , Todhunter Fern
Published: February 2025

The authors have all engaged in using social media with students as a means for collaboration across national and international boundaries for various educational purposes. Following the explosion of big data in health the authors are now moving this concept forward within undergraduate and postgraduate nursing curricula for the development of population health virtual exchanges. Nursing has a global presence and yet it appears as though students have little knowledge of the health and social care needs and provision outside their local environment. This development will allow for explorative exchange amongst students in three countries, enhancing their understanding of their own and the selected international population health needs and solutions through asking and responding to questions amongst the learning community involved. The connection of the students will be recorded for their use in reflection; of particular interest will be the use of information included by the students to answer questions about their locality.
Evaluating Pharmacists' Motivation and Job Satisfaction Factors in Saudi Hospitals
Authors: Benslimane Nabila  , Khalifa Mohamed
Published: February 2025

High turnover rate among healthcare professionals is a very expensive price that healthcare organizations might pay if they don't have the proper strategies for motivating and satisfying their employees. Healthcare organizations should be able to identify areas that require more attention. Many studies discussed the vital link that bonds job satisfaction with motivation, which has a major impact on productivity, innovation, and overall organizational performance. Our study explored the level of job satisfaction and factors that motivate pharmacists in Saudi hospitals using mixed quantitative and qualitative methods. From pharmacy managers' point of view; financial rewards are more important than non-financial incentives and benefits. This contradicts with pharmacists' opinions; who ranked recognition, promotion, job satisfaction, job feedback, autonomy and task significance among the most influential motivators to pharmacists. These results show that managers need to revise their plans and provide further attention to ensure that effective motivation and retention strategies are put in place.
Serious Game Co-Design for Children with Type 1 Diabetes
Authors: Chomutare Taridzo  , Johansen Svein-Gunnar  , Hartvigsen Gunnar  , Årsand Eirik
Published: February 2025

Co-design or participatory design has emerged as a useful concept where stakeholders and end-users have a greater stake in designing the end product. To date, few accounts exist of the use of the concept in serious game design, especially for children with chronic diseases. We report initial steps in serious game co-design for children with type 1 diabetes. Participants included 14 children (mean age 8.6 years, range of 4-13) who were invited to sketch a diabetes game. The most prevalent themes that emerged from the sketches (N=17) include blood glucose monitoring (n=12), nutrition (n=8) and insulin (n=8); all of which are consistent with diabetes education guidelines. Co-design is a promising concept for understanding children's world-view when designing healthcare games.
mHealth Quality: A Process to Seal the Qualified Mobile Health Apps
Authors: Yasini Mobin  , Beranger Jérôme  , Desmarais Pierre  , Perez Lucas  , Marchand Guillaume
Published: February 2025

A large number of mobile health applications (apps) are currently available with a variety of functionalities. The user ratings in the app stores seem not to be reliable to determine the quality of the apps. The traditional methods of evaluation are not suitable for fast paced nature of mobile technology. In this study, we propose a collaborative multidimensional scale to assess the quality of mHealth apps. During our process, the app quality is assessed in various aspects including medical reliability, legal consistency, ethical consistency, usability aspects, personal data privacy and IT security. A hypothetico-deductive approach was used in various working groups to define the audit criteria based on the various use cases that an app could provide. These criteria were then implemented into a web based self-administered questionnaires and the generation of automatic reports were considered. This method is on the one hand specific to each app because it allows to assess each health app according to its offered functionalities. On the other hand, this method is automatic, transferable to all apps and adapted to the dynamic nature of mobile technology.
An Architecture for the Integration of Clinical Data from a PEHR in a Regional Research Platform
Authors: Schreiweis Björn  , Bronsch Tobias  , Stein Katharina E.  , Nöst Stefan  , Aguduri Lakshmi S.  , Brandner Antje  , Pensold Peter  , Weiss Nicolas  , Yüksekogul Nilay  , Bergh Björn  , Heinze Oliver
Published: February 2025

Making clinical information available for research is not only relevant for healthcare institutions, but also for regional EHRs, as cross-sectorial information can be made accessible. In the INFOPAT (INFOrmation technology for PATient-oriented health care in the Rhine-Neckar metropolitan region) project we are thus implementing both, a regional personal cross-enterprise electronic health record (PEHR) and a regional research platform (RRP) based on information from the PEHR. IHE profiles are implemented to achieve interoperability between healthcare institutions electronic medical records (EMR) and PEHR on the one hand, as well as PEHR and RRP on the other hand. The use case for the RRP is cross-sectorial quality assessment and improvement for colorectal cancer based on a quality indicator (QI) approach including patients' perspectives. For semantic interoperability the responses are transferred in the form of HL7 CDA L2 documents. The resulting architecture for a RRP shows that implementing a PEHR in combination with a RRP based on international communication standards is possible. Also IHE XDS can be used for integration of patient care and biomedical research infrastructures.
The Inequality of Patient Profile Information in Japanese Hospitals
Authors: Kurihara Yukio  , Ishida Haku  , Kimura Ezen  , Gochi Akira  , Kondoh Hiroshi  , Shimai Ken-ichiro  , Nakajima Noriaki  , Tanaka Takeshi  , Ishikawa Kiyomu  , Oohara Michihiro  , Sonoda Takeharu  , Takai Kohei
Published: February 2025

A model dataset of patient profile information was created based on the items used at five Japanese university hospitals, the patient information data elements in Health Level 7 (HL7) v2.5, and the standard datasets for medical information exchange used in Japan. In order to check the validity of the model dataset, a cross-sectional survey was performed. A preliminary analysis of 20 Japanese hospitals found that most items were implemented at some hospitals, but the number of items implemented at many hospitals was rather small. This result strongly shows the necessity for a standardized dataset of patient profile information.
Applying the SNOMED CT Concept Model to Represent Value Sets for Head and Neck Cancer Documentation
Authors: Højen Anne Randorff  , Brønnum Dorthe  , Gøeg Kirstine Rosenbeck  , Elberg Pia Britt
Published: February 2025

This paper presents an analysis of the extent to which SNOMED CT is suitable for representing data within the domain of head and neck cancer. In this analysis we assess whether the concept model of SNOMED CT comply with the documentation needed within this clinical domain. Attributes from the follow-up template of the clinical quality registry for Danish Head and Neck Cancer, and their respective value sets were mapped to SNOMED CT using existing mapping guidelines. Results show that post-coordination is important to represent specific types of value sets, such as absence of findings and severities. The concept model of SNOMED CT was found suitable for representing the value sets of this material. We argue for the development of further mapping guidelines for consistent post-coordination and for initiatives that demonstrate use of this important terminological feature in actual SNOMED CT implementations.
Design of a Fine-Grained Knowledge Model for the Formalization of Clinical Practice Guidelines: Comparison with GEM
Authors: Bouaud Jacques  , Galopin Alexandre  , Oulad Kouider Assia  , Seroussi Brigitte
Published: February 2025

Published as textual documents, clinical practice guidelines (CPGs) didn't demonstrate to impact physician practices when disseminated in their original format. However, when computerized and embedded in clinical decision support systems, they appeared to be more effective. In order to ease the translation from textual to computerized CPGs, we have elaborated a fine-grained knowledge model of CPGs (FGKM) to be used when authoring CPGs. The work has been conducted on VIDALRecos® CPGs. The building of the model has followed a bottom-up iterative process starting with 15 different CPGs. The first version of the FGKM has been assessed on two new complex CPGs, and was enriched by comparison with the Guideline Elements Model (GEM). The final version of the FGKM has been tested on the 2014 Hypertension CPGs. We compared the rules automatically derived from FGKM instances to those manually extracted from textual CPGs for decision support. Results showed that difficulties such as text normalization have to be solved. The FGKM is intended to be used upstream of the process of CPGs authoring in order to ease the implementation and the update of both textual and computerized CPGs.
Feasibility of Eyetracking in Critical Care Environments – A Systematic Review
Authors: Klausen Andreas  , Röhrig Rainer  , Lipprandt Myriam
Published: February 2025

Achieving a good understanding of the socio-technical system in critical or emergency situations is important for patient safety. Research in human-computer interaction in the field of anesthesia or surgery has the potential to improve usability of the user interfaces and enhance patient safety. Therefore eye-tracking is a technology for analyzing gaze patterns. It can also measure what is being perceived by the physician during medical procedures. The aim of this review is the applicability of eye-tracker in the domain of simulated or real environments of anesthesia, surgery or intensive care. We carried out a literature research in PubMed. Two independent researchers screened the titles and abstracts. The remaining 8 full-papers were analyzed based on the applicability of eye-trackers. The articles contain topics like training of surgeons, novice vs. experts or the cognitive workload. None of the publications address our goal. The applicability or limitations of the eye-tracker technology were stated incidentally.
Proposing an Evidence-Based Strategy for Software Requirements Engineering
Authors: Lindoerfer Doris  , Mansmann Ulrich
Published: February 2025

This paper discusses an evidence-based approach to software requirements engineering. The approach is called evidence-based, since it uses publications on the specific problem as a surrogate for stakeholder interests, to formulate risks and testing experiences. This complements the idea that agile software development models are more relevant, in which requirements and solutions evolve through collaboration between self-organizing cross-functional teams. The strategy is exemplified and applied to the development of a Software Requirements list used to develop software systems for patient registries.
Impact of Participatory Design for Drug-Drug Interaction Alerts. A Comparison Study Between Two Interfaces
Authors: Luna Daniel  , Otero Carlos  , Risk Marcelo  , Stanziola Enrique  , González Bernaldo de Quirós Fernán
Published: February 2025

Decision support systems for alert drug-drug interactions have been shown as valid strategy to reduce medical error. Even so the use of these systems has not been as expected, probably due to the lack of a suitable design. This study compares two interfaces, one of them developed using participatory design techniques (based on user centered design processes). This work showed that the use of these techniques improves satisfaction, effectiveness and efficiency in an alert system for drug-drug interactions, a fact that was evident in specific situations such as the decrease of errors to meet the specified task, the time, the workload optimization and users overall satisfaction with the system.
Universal Design as a Booster for Housing Quality and Architectural Practice
Authors: Denizou Karine
Published: February 2025

Norwegian central government has for the last decade increasingly focused on universal design. Fundamental changes in the Norwegian building code and corresponding regulations in 2010 give an apparently clear framework for the implementation of accessibility and universal design. However, it seems that neither increased awareness of accessibility requirements and universal design, nor compliance with the building code guarantees improvement of housing quality and usability. The Norwegian regulations have gone further in the direction of performance requirements than most other countries. This applies to all types of requirements, including requirements for usability, functionality and accessibility. Hardly any specifications are to be found in the regulations. Ideally, this lack of specifications should give designers the opportunity to develop innovative answers and hence to respond to different contexts and needs. Still, many architects and builders ask for clear specifications, in order to simplify and speed up design processes and make control of solutions easier. Many architects understand guidelines as minimum requirements, and are thus reproducing the identical solutions without considering the context and the needs of the users. They see accessibility as another regulatory pressure and requirements as restrictions rather than positive incentives. However, there are examples of designers who have internalised the regulatory framework and thus are able to create and integrate inclusive design in their daily work. Based on recent research conducted by SINTEF Building and Infrastructure and financed by the Norwegian State Housing Bank, this paper presents examples of practice where dwellings have been developed within a framework of universal design. Focus of the research has been on the approach of the design team and their understanding and use of the regulatory framework in order to create better homes in dialogue with the building authorities. Main objectives are to:
Eliciting Parents' Individual Requirements for an Inclusive Digital School System
Authors: Eftring Håkan  , Rassmus-Gröhn Kirsten  , Hedvall Per-Olof
Published: February 2025

Parents often have a busy time sorting out their life puzzles, including getting information about their children's activities in school. More and more communication between teachers and parents take place via digital school systems. It can be hard for parents to find the information they are looking for and the teacher decides when information is sent and what communication method to use. All parents, but especially parents with disabilities, might have individual preferences on how to receive information and how to adapt meetings at school. In this paper we present a project where we involved parents and teachers in focus groups, an idea workshop and iterative user trials of a digital prototype. The goal was to elicit parents' individual requirements for an inclusive digital school system, where they can store their individual preferences about how and when to receive information from school and what requirements they have on meetings at school. Preliminary results show that we managed to create open and focused discussions among parents and teachers. The parents reacted very positively on an onboarding page with the possibility to quickly and easily enter preferences after their first log in, but more work needs to be done on how preferences are categorized on the onboarding page. Finally, parents need to get clear feedback from teachers and school when they have entered or updated preferences, so they can trust that their preferences will be met.
Wheeled Mobility Devices and Access to Buildings
Authors: Ahosseini Alborz
Published: February 2025

Developments in the design of assistive equipment have a huge bearing on the built environment and the corresponding accessibility norms. The main goal of this study is to investigate the new accessibility standards for building entrance and elevators/lifts with respect to the evolution in wheeled mobility devices.
Developing a User-Centred Planning Tool for Young Adults with Development Disorders: A Research-Based Teaching Project
Authors: Ribu Kirsten  , Patel Tulpesh
Published: February 2025

People with development disorders, for instance autism, need structured plans to help create predictability in their daily lives. Digital plans can facilitate enhanced independency, learning, and quality of life, but existing apps are largely general purpose and lack the flexibility required by this specific but heterogeneous user group. Universal design is both a goal and a process and should be based on a holistic approach and user-centered design, interacting with the users in all stages of the development process. At Oslo and Akershus University College (HiOA) we conducted a research-based teaching project in co-operation with the Department of Neuro-habilitation at Oslo University Hospital (OUS) with two employees acting as project managers and students as developers. Three groups of Computer Science bachelor students developed digital prototypes for a planning tool for young adults with pervasive development disorders, who live either with their families or in supervised residences, and do not receive extensive public services. The students conducted the initial planning phase of the software development process, focusing on prototyping the system requirements, whilst a professional software company programmed the end solution. The goal of the project was to develop flexible and adaptive user-oriented and user-specific app solutions for tablets that can aid this diverse user group in structuring daily life, whereby, for example, photos of objects and places known to the individual user replace general pictures or drawings, and checklists can be elaborate or sparse as necessary. The three student groups worked independently of each other and created interactive working prototypes based on tests, observations and short interviews with end users (both administrators and residents) and regular user feedback from the project managers. Three very different solutions were developed that were of high enough quality that an external software company were able to continue the work and create a beta version of the app. The first phase in software development process is always challenging and time consuming. Using a research-based teaching approach allowed us to not only save time and expense in the development phase, but, importantly, allowed us to thoroughly investigate a variety of aspects of the problem to create an accessible solution, whilst leveraging our students' knowledge, competencies and creativity. The next stage will be to evaluate the beta version of the app and study its impact on the user's quality of life. Although the end solution is designed for a specific user group, the built-in flexibility of its structure and function means there is the inherent potential to open it up to all users. The universal benefit lies in the flexibility of the solution.
Local and Regional Authorities as Resources for Implementing Universal Design Policy in Norway
Authors: Lund Einar
Published: February 2025

The municipalities and regional authorities are in general resources for achieving national goals. Their management and works are crucial to the development and implementation of Universal Design. Through several programmes, national authorities have worked for activating the local and regional levels. The results are visible. We can see a long-term national strategy to help make society accessible to everyone and prevent discrimination. Participating municipalities and regional authorities are now able to create their own policy and strategies and implement solutions. The national programs have involved interested and motivated municipalities. All the 18 counties in Norway have been involved more or less in different periods and the same with up to a third of the about good 400 municipalities.
Applying the Resilient Health System Framework for Universal Health Coverage
Authors: Ho Kendall  , Al-Shorjabji Najeeb  , Brown Ed  , Zelmer Jennifer  , Gabor Nancy  , Maeder Anthony  , Marcelo Alvin  , Ritz Derek  , Messina Luiz  , Loyola Margarita  , Abbott Patricia  , Nazira Jaffer  , McKinnon Annette  , Dissanayake Vajira  , Akeel Aisha  , Gardner Neil  , Doyle Thomas
Published: February 2025

Since the 1978 Declaration of Alma-Ata affirming health as a fundamental human right, policy-makers and stakeholders have proposed many different strategies to achieve the goal of ‘health for all’. However, globally there still remains a lack of access to health information and quality health care, especially in low- and middle-income countries (LMIC). Digital health holds great promise to improve access and quality of care. We propose using the “resilient health system framework” as a guide to scale-up digital health as a means to achieve universal health care (UHC) and health for all. This article serves as a call to action for all governments to include population-based digital health tools as a foundational element in on-going health system priorities and service delivery.
Family and Practitioner Perspectives on Telehealth for Services to Young Children with Autism
Authors: Iacono Teresa  , Dissanayake Cheryl  , Trembath David  , Hudry Kristelle  , Erickson Shane  , Spong Jo
Published: February 2025

Telehealth offers the potential to address inequalities in autism service access for young children living in regional and rural areas with limited access to autism specialists. Our aim was to explore parent and practitioner uses of technology, and views about telehealth, including perceived barriers, for autism early intervention service delivery in a regional town in Australia. Fifteen mothers and 19 front-line autism practitioners completed surveys distributed by local autism service and support providers in the regional town; eight front-line practitioners from one service participated in interviews. Mothers and practitioners had access to technology that could be used for video-communication, but had little or no experience with telehealth. Mothers appeared more willing to try telehealth for receiving autism services than practitioners appeared to believe, and practitioners preferred to use it for consulting with other professionals and professional development. Barriers to telehealth included limited experience and practitioners not knowing what a telehealth service would look like, poor access to reliable and high speed internet, lack of skill and technical supports, and practitioners believing families preferred face-to-face services. The success of telehealth in this regional town will rely on better infrastructure, and upskilling practitioners in evidence-based autism interventions so they can provide the required support remotely. Use of telehealth to upskill practitioners in evidence-based practice could provide a first step in ensuring equitable access to expert autism services to regional and rural families.
Mitochondrial Myopathies and Disorders
Authors: Barness Lewis A.  , Wong Kondi
Published: February 2025

Genetic disorders of mitochondria cause disease when they reduce subcellular energy production through a variety of impairments in the electron transport chain, thus decreasing oxidative phosphorylation. Such abnormalities typically lead to neuropathies and/or myopathies including cardiomyopathies. Hepatic and renal pathology may also occur. The age of onset and severity are variable, but signs and symptoms are often present during infancy. The metabolic hallmarks include lactic acidosis, an increased ratio of blood lactate to pyruvate, and ketonemia. Muscle biopsies show characteristic ragged red fibers, which are obvious with trichrome staining. Some disorders which are inherited through the mother, source of all mitochondrial DNA, lead to early blindness due to progressive optic neuropathy, i.e., Leber's Hereditary Optic Neuropathy. Exciting recent research with gene replacement therapy and stem cell technology has provided new insights and hope for patients with genetic blindness. Other disorders affecting mitochondrial DNA mutations may also eventually be treated with molecular (gene replacement) or advanced cellular (stem cell) therapeutic strategies. In addition, early diagnosis through newborn screening is now routinely achieved for some disorders such as biotinidase deficiency, allowing curative therapy through nutritional supplements.
Technology-Based Healthcare for Nursing Education Within The Netherlands: Past, Present and Future
Authors: Koster Ybranda  , van Houwelingen Cornelis T.M.
Published: February 2025

At the present time, nearly all Dutch nursing schools are searching for suitable ways to implement technology-based healthcare in their curriculum. Some Universities chose elective education, others a mandatory solution. Several studies were executed to determine competencies needed by nurses in order to work with technology-based healthcare. In 2016 a nationwide new curriculum for nurses has been published. Providing technology-based healthcare is included under the core competencies of this new curriculum. All baccalaureate nursing educational institutes must implement this new curriculum at the start of 2016 which will have a huge impact on the implementation of technology-based healthcare in the education programs. In the future, technology centers from Universities will collaborate and specialize, partner with technology companies and crossovers between information and communication technology and healthcare education will be expanded.
Competencies Related to Informatics and Information Management for Practicing Nurses and Nurses Leaders in Brazil and South America
Authors: Barbosa Sayonara de Fatima Faria
Published: February 2025

Informatics and information management competency has an important role for nursing. However, these competencies in Brazil and South America lack definition, and are just beginning to develop in these regions with different realities. This chapter presents information related to the development of informatics competencies for nursing in these areas.
From Prototype to Product: Making Participatory Design of mHealth Commercially Viable
Authors: Andersen Tariq O.  , Bansler Jørgen P.  , Kensing Finn  , Moll Jonas
Published: February 2025

This paper delves into the challenges of engaging patients, clinicians and industry stakeholders in the participatory design of an mHealth platform for patient-clinician collaboration. It follows the process from the development of a research prototype to a commercial software product. In particular, we draw attention to four major challenges of (a) aligning the different concerns of patients and clinicians, (b) designing according to clinical accountability, (c) ensuring commercial interest, and (d) dealing with regulatory constraints when prototyping safety critical health Information Technology. Using four illustrative cases, we discuss what these challenges entail and the implications they pose to Participatory Design. We conclude the paper by presenting lessons learned.
Expanding the Reach of Continuing Educational Offerings Through a Web-Based Virtual Network: The Experience of InspireNet
Authors: Frisch Noreen C.  , Atherton Pat  , Borycki Elizabeth M.  , Mickelson Grace  , Black Agnes  , Novak Lauscher Helen  , Cordeiro Jennifer
Published: February 2025

Virtual platforms using webinars, e-posters, e-newsletters, wikis and blogs connect people who have common interests in new ways. When those individuals are healthcare providers, a professional network that operates on a virtual platform can support their needs for learning, professional development and information currency. The practice of e-learning for continuing professional development is emerging , particularly in nursing where shift work shift inhibits their ability to attend conferences and classes. This article reports the experience of the InspireNet network that provided e-learning models to: 1) provide opportunities for healthcare providers to organize themselves into learning communities through development of electronic communities of practice; 2) support learning on demand; and 3) dramatically increase the reach of educational offerings.
Deriving a Set of Privacy Specific Heuristics for the Assessment of PHRs (Personal Health Records)
Authors: Furano Riccardo F.  , Kushniruk Andre  , Barnett Jeff
Published: February 2025

With the emergence of personal health record (PHR) platforms becoming more widely available, this research focused on the development of privacy heuristics to assess PHRs regarding privacy. Existing sets of heuristics are typically not application specific and do not address patient-centric privacy as a main concern prior to undergoing PHR procurement. A set of privacy specific heuristics were developed based on a scoping review of the literature. An internet-based commercially available, vendor specific PHR application was evaluated using the derived set of privacy specific heuristics. The proposed set of privacy specific derived heuristics is explored in detail in relation to ISO 29100. The assessment of the internet-based commercially available, vendor specific PHR application indicated numerous violations. These violations were noted within the study. It is argued that the new derived privacy heuristics should be used in addition to Nielsen's well-established set of heuristics. Privacy specific heuristics could be used to assess PHR portal system-level privacy mechanisms in the procurement process of a PHR application and may prove to be a beneficial form of assessment to prevent the selection of a PHR platform with a poor privacy specific interface design.
Designing Novel Health ICTs to Support Work, Not Generate It: Five Principles
Authors: Peddie David  , Small Serena  , Wickham Maeve  , Bailey Chantelle  , Hohl Corinne  , Balka Ellen
Published: February 2025

In this paper, we offer five principles to inform how health ICT designers and healthcare organizations address and mitigate issues relating to clinician documentation burden. We draw on our experience and empirical work designing an ICT intervention, ActionADE, to illustrate how our team developed and will use these principles to ease documentation burden for clinician-users.
Complex Clinical Communication Practices: How Do Information Receivers Assimilate and Act Upon Information for Patient Care?
Authors: Wong Ming Chao  , Yee Kwang Chien  , Turner Paul
Published: February 2025

Improving clinical communication is imperative to improving the quality and safety of patient care. Significant efforts have been made to improve clinical communication and patient safety, guided by the mantra of “the right information, to the right person, in the right place, at the right time”. The design and implementation of information communication technologies (ICTs) has been considered as one of the major developments in improving patient care. Clinical communication in today's clinical practice is complex and involves multi-disciplinary teams using different types of media for information transfer. This paper argues that traditional communication theories fail to adequately capture and describe contemporary clinical communicative practices or to provide insight into how information transferred is actually assimilated and/or utilised for patient care. This paper argues for the need to more fully consider underlying assumptions about the role of information in clinical communication and to recognise how the attributes of information receivers, especially where ICTs are deployed influence outcomes. The paper presents a discussion regarding the need to consider information receivers as the foundation for clinical communication improvement and future design and development of ICTs to improve patient care.
The Connecting South West Ontario (cSWO) Benefits Model: An Approach for the Collaborative Capture of Value of Electronic Health Records and Enabling Technology
Authors: Alexander Ted  , Huebner Lori-Anne  , Alarakhia Mohamed  , Hollohan Kirk
Published: February 2025

This paper explains the benefits model developed and deployed by the connecting South West Ontario (cSWO) program. The cSWO approach is founded on the principles of enabling clinical and organizational value and the recognition that enabling requires a collaborative approach that can include several perspectives. We describe our approach which is aimed at creating a four-part harmony between change management and adoption, best practice research and quality indicators, data analytics and clinical value production.
Learning Differentially Expressed Gene Pairs in Microarray Data
Authors: Xia Xiao-Lei  , Brophy Sinead  , Zhou Shang-Ming
Published: February 2025

To identify differentially expressed genes (DEGs) in analysis of microarray data, a majority of existing filter methods rank gene individually. Such a paradigm could overlook the genes with trivial individual discriminant powers but significant powers of discrimination in their combinations. This paper proposed an impurity metric in which the number of split intervals for each feature is considered as a parameter to be optimized for gaining maximal discrimination. The proposed method was first evaluated by applying to a synthesized noisy rectangular grid dataset, in which the significant feature pair which forms a rectangular grid pattern was successfully recognized. Furthermore, applying to the identification of DEGs on colon microarray data, the proposed method demonstrated that it could become an alternative to Fisher's test for the prescreening of genes which led to better performance of the SVM-RFE method.
An Approach for Enhancing Adoption, Use and Utility of Shared Digital Health Records in Rural Australian Communities
Authors: Almond Helen  , Cummings Elizabeth  , Turner Paul
Published: February 2025

Internationally, shared digital health records are considered an important addition to improving modern health care provision. Australia launched its version, My Health Record (MyHR), in 2012 but has experienced low adoption and challenges in practical implementation and evaluation. Individuals living with complex and chronic conditions in rural and remote communities often experience challenges in obtaining equitable access to health care provision. They are also supposed to face additional barriers to adopting and using eHealth services. This paper reports on research investigating adoption, use and utility of MyHR, in rural remote Australian community settings. Based on this research an approach for improving national roll out of MyHR is presented. The approach highlights a means to understand and engage communities with complex care needs, to support their adoption and use of digital tools. It also draws attention to holistic methods for evaluating and assessing impact at individual, community and health care provision levels.
HEMIC Project: Design of a Clinical Information Modelling Tool Based on ISO13972 Technical Specification
Authors: Moreno-Conde Alberto  , Sanchez-Laguna Francisco  , Marin-Bastida Bidatzi  , Romero-Tabares Antonio  , Martin-Sánchez Eva  , Kalra Dipak  , Parra-Calderón Carlos Luis
Published: February 2025

The Andalusian Health Service is the public healthcare provider for 8.302.923 inhabitants in the South Spain. This organization coordinates primary and specialized care with an IT infrastructure composed by multiple Electronic Health Record Systems. According to the large volume of healthcare professionals involved, there is a need for providing a consistent management of information through multiple locations and systems. The HEMIC project aims to address this need developing and validating a methodology based on a software tool for standardizing information contained within EHR systems. The developed tool has been designed for supporting the participation of healthcare professionals the establishment of mechanisms for information governance. This research presents the requirements and designs for of a software tool focused on the adoption of recognized best practice in clinical information modeling. The designed tool has a Service Oriented Architecture that will be able to integrate terminology servers and repositories of clinical information models as part of the modeling process. Moreover, the defined tool organizes clinicians, IT developers and terminology experts involved in the modeling process in three levels to promote their coordination in the definition, specialization and validation of clinical information models. In order to ensure the quality of the developed clinical information models, the defined tool is based on the requirements defined in the ISO13972 Technical Specification.