A Pipeline for the Usage of the Core Data Set of the Medical Informatics Initiative for Process Mining - A Technical Case Report

INTRODUCTION

Process Mining (PM) has emerged as a transformative tool in healthcare, facilitating the enhancement of process models and predicting potential anomalies. However, the widespread application of PM in healthcare is hindered by the lack of structured event logs and specific data privacy regulations.

CONCEPT

This paper introduces a pipeline that converts routine healthcare data into PM-compatible event logs, leveraging the newly available permissions under the Health Data Utilization Act to use healthcare data.

IMPLEMENTATION

Our system exploits the Core Data Sets (CDS) provided by Data Integration Centers (DICs). It involves converting routine data into Fast Healthcare Interoperable Resources (FHIR), storing it locally, and subsequently transforming it into standardized PM event logs through FHIR queries applicable on any DIC. This facilitates the extraction of detailed, actionable insights across various healthcare settings without altering existing DIC infrastructures.

LESSONS LEARNED

Challenges encountered include handling the variability and quality of data, and overcoming network and computational constraints. Our pipeline demonstrates how PM can be applied even in complex systems like healthcare, by allowing for a standardized yet flexible analysis pipeline which is widely applicable.The successful application emphasize the critical role of tailored event log generation and data querying capabilities in enabling effective PM applications, thus enabling evidence-based improvements in healthcare processes.

Status of MyHealthWay and Suggestions for Widespread Implementation, Emphasizing the Utilization and Practical Use of Personal Medical Data

OBJECTIVES

In the Fourth Industrial Revolution, there is a focus on managing diverse medical data to improve healthcare and prevent disease. The challenges include tracking detailed medical records across multiple institutions and the necessity of linking domestic public medical entities for efficient data sharing. This study explores MyHealthWay, a Korean healthcare platform designed to facilitate the integration and transfer of medical data from various sources, examining its development, importance, and legal implications.

METHODS

To evaluate the management status and utilization of MyHealthWay, we analyzed data types, security, legal issues, domestic versus international issues, and infrastructure. Additionally, we discussed challenges such as resource and infrastructure constraints, regulatory hurdles, and future considerations for data management.

RESULTS

The secure sharing of medical information via MyHealthWay can reduce the distance between patients and healthcare facilities, fostering personalized care and self-management of health. However, this approach faces legal challenges, particularly relating to data standardization and access to personal health information. Legal challenges in data standardization and access, particularly for secondary uses such as research, necessitate improved regulations. There is a crucial need for detailed governmental guidelines and clear data ownership standards at institutional levels.

CONCLUSIONS

This report highlights the role of Korea's MyHealthWay, which was launched in 2023, in transforming healthcare through systematic data integration. Challenges include data privacy and legal complexities, and there is a need for data standardization and individual empowerment in health data management within a systematic medical big data framework.

Adoption of Electronic Medical Records in Healthcare Facilities in the Emirate of Dubai

OBJECTIVES

This paper aimed to assess the adoption of electronic medical records (EMRs) in healthcare facilities in Dubai, the largest city in the United Arab Emirates (UAE) and a location where extensive healthcare services are provided. It explored the challenges, milestones, and accomplishments associated with this process.

METHODS

A situation analysis was conducted by contacting 2,089 healthcare facilities in Dubai to determine whether they had implemented EMR in their medical practices and to identify the challenges they faced during this process. Additionally, the Electronic Medical Record Adoption Model (EMRAM) was utilized to measure the maturity level of hospitals in terms of EMR adoption. The EMRAM stages were rated on a scale from 0 to 7, with 0 representing the least mature stage and 7 the most mature.

RESULTS

By September 2023, all hospitals (100%, n = 54) and 75% of private clinics (n = 1,460) in Dubai had implemented EMRs. Several challenges were identified, including the absence of EMRs within the healthcare facility, having an EMR with a low EMRAM score, or the lack of a unified interoperability standard. Additionally, the absence of a clear licensing program for EMR vendors, whether standalone or cloud-based, was among the other challenges noted.

CONCLUSIONS

EMR implementation in healthcare facilities in Dubai is at a mature stage. However, further efforts are required at both the decision-making and technical levels. We believe that our experience can benefit other countries in the region in implementing EMRs and using EMRAM to assess their health information systems.

Codesign of health technology interventions to support best-practice perioperative care and surgical waitlist management

OBJECTIVES

This project aimed to determine where health technology can support best-practice perioperative care for patients waiting for surgery.

METHODS

An exploratory codesign process used personas and journey mapping in three interprofessional workshops to identify key challenges in perioperative care across four health districts in Sydney, Australia. Through participatory methodology, the research inquiry directly involved perioperative clinicians. In three facilitated workshops, clinician and patient participants codesigned potential digital interventions to support perioperative pathways. Workshop output was coded and thematically analysed, using design principles.

RESULTS

Codesign workshops, involving 51 participants, were conducted October to November 2022. Participants designed seven patient personas, with consumer representatives confirming acceptability and diversity. Interprofessional team members and consumers mapped key clinical moments, feelings and barriers for each persona during a hypothetical perioperative journey. Six key themes were identified: 'preventative care', 'personalised care', 'integrated communication', 'shared decision-making', 'care transitions' and 'partnership'. Twenty potential solutions were proposed, with top priorities a digital dashboard and virtual care coordination.

DISCUSSION

Our findings emphasise the importance of interprofessional collaboration, patient and family engagement and supporting health technology infrastructure. Through user-based codesign, participants identified potential opportunities where health technology could improve system efficiencies and enhance care quality for patients waiting for surgical procedures. The codesign approach embedded users in the development of locally-driven, contextually oriented policies to address current perioperative service challenges, such as prolonged waiting times and care fragmentation.

CONCLUSION

Health technology innovation provides opportunities to improve perioperative care and integrate clinical information. Future research will prototype priority solutions for further implementation and evaluation.

Challenges in surveillance of all cancer cases: The Chilean National Cancer Registry

Cancer causes millions of deaths worldwide, making its registration essential. There are clinical, hospital, and population-based registries in place. The latter is the gold standard for information on cancer incidence and survival in a defined region. Chile has five population-based registries located in specific areas of the country. The Chilean National Cancer Registry emerged with the challenge of creating a tool encompassing all three types of registries to identify the number of cancer cases by type. Its design involved a series of actions to achieve consensus among various actors regarding information, validation, and events to be registered. Four stages were identified in the care and registration process: suspected diagnosis, morphological confirmation (biopsy), clinical resolution (oncology committee, including treatment recommendations), treatment, and oncological follow-up. The platform's development (from 2018 to 2021) involved gathering information and agreements on the requirements for co-designing the registry, including a successful pilot program with over 20 public and private healthcare facilities that recorded nearly 7500 cancer cases. The deployment and use of the National Cancer Registry at a national level depends on the healthcare authority. It is an information system that continuously and systematically collects, stores, processes, and analyzes data on all cancer cases and types occurring in the country. This work presents the design and development of the tool, the challenges addressed, as well as its strengths and weaknesses.

Review of Qualitative Research Methods in Health Information System Studies

OBJECTIVES

The aim of this study was to review hospital-based health information system (HIS) studies that used qualitative research methods and evaluate their methodological contexts and implications. In addition, we propose practical guidelines for HIS researchers who plan to use qualitative research methods.

METHODS

We collected papers published from 2012 to 2022 by searching the PubMed and CINAHL databases. As search keywords, we used specific system terms related to HISs, such as "electronic medical records" and "clinical decision support systems," linked with their operational terms, such as "implementation" and "adaptation," and qualitative methodological terms such as "observation" and "in-depth interview." We finally selected 74 studies that met this review's inclusion criteria and conducted an analytical review of the selected studies.

RESULTS

We analyzed the selected articles according to the following four points: the general characteristics of the selected articles; research design; participant sampling, identification, and recruitment; and data collection, processing, and analysis. This review found methodologically problematic issues regarding researchers' reflections, participant sampling methods and research accessibility, and data management.

CONCLUSIONS

Reports on the qualitative research process should include descriptions of researchers' reflections and ethical considerations, which are meaningful for strengthening the rigor and credibility of qualitative research. Based on these discussions, we suggest guidance for conducting ethical, feasible, and reliable qualitative research on HISs in hospital settings.

Call to digital health leaders: test and leverage this guideline to support health information technology implementation in practice

BACKGROUND

Health information technology (HIT) is increasingly used to enable health service/system transformation. Most HIT implementations fail to some degree; very few demonstrate sustainable success. No guidelines exist for health service leaders to leverage factors associated with success. The purpose of this paper is to present an evidence-based guideline for leaders to test and leverage in practice.

METHODS

This guideline was developed from a literature review and refined by a set of eight interviews with people in senior HIT roles, which were thematically analysed. It was refined in the consultancy work of the first author and confirmed after minor refinements.

RESULTS

Five key actions were identified: relationships, vision, HIT system attributes, constant evaluation and learning culture.

CONCLUSIONS

This guideline presents a significant opportunity for health system leaders to systematically check relevant success factors during the implementation process of single projects and regional/national programmes.

Implementer report: ICD-10 code F44.5 review for functional seizure disorder

OBJECTIVE

The study aimed to measure the validity of International Classification of Diseases, 10th Edition (ICD-10) code F44.5 for functional seizure disorder (FSD) in the Veterans Affairs Connecticut Healthcare System electronic health record (VA EHR).

METHODS

The study used an informatics search tool, a natural language processing algorithm and a chart review to validate FSD coding.

RESULTS

The positive predictive value (PPV) for code F44.5 was calculated to be 44%.

DISCUSSION

ICD-10 introduced a specific code for FSD to improve coding validity. However, results revealed a meager (44%) PPV for code F44.5. Evaluation of the low diagnostic precision of FSD identified inconsistencies in the ICD-10 and VA EHR systems.

CONCLUSION

Information system improvements may increase the precision of diagnostic coding by clinicians. Specifically, the EHR problem list should include commonly used diagnostic codes and an appropriately curated ICD-10 term list for 'seizure disorder,' and a single ICD code for FSD should be classified under neurology and psychiatry.

Current Status and Key Issues of Data Management in Tertiary Hospitals: A Case Study of Seoul National University Hospital

OBJECTIVES

In the era of the Fourth Industrial Revolution, where an ecosystem is being developed to enhance the quality of healthcare services by applying information and communication technologies, systematic and sustainable data management is essential for medical institutions. In this study, we assessed the data management status and emerging concerns of three medical institutions, while also examining future directions for seamless data management.

METHODS

To evaluate the data management status, we examined data types, capacities, infrastructure, backup methods, and related organizations. We also discussed challenges, such as resource and infrastructure issues, problems related to government regulations, and considerations for future data management.

RESULTS

Hospitals are grappling with the increasing data storage space and a shortage of management personnel due to costs and project termination, which necessitates countermeasures and support. Data management regulations on the destruction or maintenance of medical records are needed, and institutional consideration for secondary utilization such as long-term treatment or research is required. Government-level guidelines for facilitating hospital data sharing and mobile patient services should be developed. Additionally, hospital executives at the organizational level need to make efforts to facilitate the clinical validation of artificial intelligence software.

CONCLUSIONS

This analysis of the current status and emerging issues of data management reveals potential solutions and sets the stage for future organizational and policy directions. If medical big data is systematically managed, accumulated over time, and strategically monetized, it has the potential to create new value.

ELGA Terminology Server for Clinical Decision Support: A Case-Study Using an Existing Knowledge Base, CDS Hooks and FHIR

BACKGROUND

There are many medical knowledge bases with potential for supporting medical professionals in their decision-making during routine care, yet usage of these sources remains low. Standardized linking of Clinical Decision Support (CDS) applications and existing medical knowledge bases is not a common practice.

OBJECTIVES

Using existing eHealth standards to increase the utilization of knowledge bases and implement a prototype.

METHODS

Linking an existing online knowledge base via a FHIR CodeSystem supplement to the Austrian national EHR (ELGA) terminology server and accessing these data using CDS Hooks and FHIR.

RESULTS

We tested the approach by incorporating photosensitivity data of medications into a local copy of the Austrian terminology server. These data are directly used by a CDS Hooks compliant CDS service.

CONCLUSION

The Austrian Terminology Server could be an important interface to access existing knowledge bases from within EHR systems. FHIR and CDS Hooks could lead the way for a simple and open integration of CDS services into EHR systems.

Primary health care coverage in Brazil: a dataset from 1998 to 2020

OBJECTIVES

Primary health care builds the backbone of an effective healthcare system and can improve population health, reduce cost growth, and lessen inequality. We offer a machine-readable and open-access dataset on primary health care coverage in Brazil from 1998 to 2020. This dataset is interoperable with epidemiological data from two major studies and reusable by the research community worldwide for other purposes, such as monitoring progress toward universal health coverage and studying the association between primary health care and health outcomes.

DATA DESCRIPTION

The dataset gathers official and public information from the "e-Gestor AB" platform of the Ministry of Health of Brazil and restricted data obtained by the Brazilian Access to Information Law. It includes 1,509,870 observations and 35 attributes aggregated by months/years and policy-relevant geographic units (country, macroregions, states, municipalities, and capitals) on primary health care team count and their absolute and relative population coverage estimates, information on the More Doctors Program implementation and physician counts, and spatial, demographic, and socioeconomic characteristics. We automated all data processing and curation in the free and open software R. The codes can be audited, replicated, and reused to produce alternative analyses.

Exploring the feasibility of establishing a core set of sexual, reproductive, maternal, newborn, child, and adolescent health indicators in humanitarian settings: results from a multi-methods assessment in Jordan

BACKGROUND

Reliable and rigorously collected sexual, reproductive, maternal, newborn, child, and adolescent health (SRMNCAH) data in humanitarian settings is often sparse and variable in quality across different humanitarian settings. To address this gap in data quality, the World Health Organization (WHO) developed a core set of indicators for monitoring and evaluating SRMNCAH services and outcomes in humanitarian settings, and assessed their feasibility in the field in Jordan, in addition to three other countries; with the goal of aggregating information from global consultations and field-level assessments to reach consensus on a set of core SRMNCAH indicators for services and outcome evaluation in humanitarian settings among WHO global partners.

METHODS

The feasibility assessment in Jordan focused on the following constructs: relevance/usefulness, feasibility of measurement, systems and resources, and ethical issues. The multi-methods assessment included five components; a desk review, key informant interviews, focus group discussions, facility assessments, and observational sessions.

RESULTS

Findings suggest that there is widespread support among regional, national, as well as global stakeholders for developing a core list of SRMNCAH indicators for monitoring and evaluation of services and outcomes in humanitarian settings in Jordan. There are numerous resources and data collection systems that could be leveraged, built upon, and improved to ensure the feasibility of collecting this proposed set of indicators. However, the data collection load requested from donors, the national government, international and UN agencies, coordination/cluster systems must be better harmonized, standardized, and less burdensome.

CONCLUSIONS

Despite stakeholder support in developing a core set of indicators, this would only be useful if it has the buy-in from the international community. Greater harmonization and coordination, alongside increased resource allocation, would improve data collection efforts and allow stakeholders to meet indicators' reporting requirements.

Routine health information use among healthcare providers in Ethiopia: a systematic review and meta-analysis

INTRODUCTION

Healthcare policy formulation, programme planning, monitoring and evaluation, and healthcare service delivery as a whole are dependent on routinely generated health information in a healthcare setting. Several individual research articles on the utilisation of routine health information exist in Ethiopia; however, each of them revealed inconsistent findings.

OBJECTIVE

The main aim of this review was to combine the magnitude of routine health information use and its determinants among healthcare providers in Ethiopia.

METHODS

Databases and repositories such as PubMed, Global Health, Scopus, Embase, African journal online, Advanced Google Search and Google Scholar were searched from 20 to 26 August 2022.

RESULT

A total of 890 articles were searched but only 23 articles were included. A total of 8662 (96.3%) participants were included in the studies. The pooled prevalence of routine health information use was found to be 53.7% with 95% CI (47.45% to 59.95%). Training (adjusted OR (AOR)=1.56, 95% CI (1.12 to 2.18)), competency related to data management (AOR=1.94, 95% CI (1.35 to 2.8)), availability of standard guideline (AOR=1.66, 95% CI (1.38 to 1.99)), supportive supervision (AOR=2.07, 95% CI (1.55 to 2.76)) and feedback (AOR=2.20, 95% CI (1.30 to 3.71)) were significantly associated with routine health information use among healthcare providers at p value≤0.05 with 95% CI.

CONCLUSION

The use of routinely generated health information for evidence-based decision-making remains one of the most difficult problems in the health information system. The study's reviewers suggested that the appropriate health authorities in Ethiopia invest in enhancing the skills in using routinely generated health information.

PROSPERO REGISTRATION NUMBER

CRD42022352647.

Organizational and health professional readiness for the implementation of electronic medical record system: an implication for the current EMR implementation in northwest Ethiopia

OBJECTIVE

The WHO developed a manual outlining the preliminary organizational and health professionals' readiness to implement electronic medical records (EMR). On the other hand, the readiness assessment in Ethiopia only includes the evaluation of health professionals, leaving out organisational readiness components. As a result, this research aimed to determine health professionals' and organizational readiness to implement EMR at a specialized teaching hospital.

METHODS

An institutional-based cross-sectional study design was conducted among 423 health professionals and 54 managers. Self-administered and pretested questionnaires were used to collect data. Binary logistic regression analysis was used to identify factors associated with health professionals' readiness for EMR implementation. An OR with a 95% CI and p<0.05 was used to determine the strength of the association and the statistical significance, respectively.

RESULTS

In this study, 53.7% management capacity, 33.3% finance and budget capacity, 42.6% operational capacity, 37.0% technology capability and 53.7% organisational alignment among the five dimensions evaluated to assess an organisation's readiness to implement an EMR system. Of 411 health professionals in this study, 173 (42.1%) with (95 CI 37.3% to 46.8%) were ready to implement an EMR system at the hospital. Sex (AOR 2.69, 95% CI 1.73 to 4.18), basic computer training (AOR 1.59, 95% CI 1.02 to 2.46), knowledge of EMR (AOR 1.88, 95% CI 1.19 to 2.97) and attitudes towards EMR (AOR 1.65, 95% CI 1.05 to 2.59) were significantly associated with health professionals' readiness towards EMR system implementation.

CONCLUSIONS

Findings showed that most dimensions of organizational readiness for EMR implementation were below 50%. This study also revealed a lower level of EMR implementation readiness among health professionals compared with previous research studies' results. To improve organisational readiness to implement an electronic medical record system, a focus on management capability, financial and budget capability, operational capability, technical capability and organisational alignment was crucial. Likewise, having basic computer training, giving special attention to female health professionals and improving health professionals' knowledge of and attitudes towards EMR could help improve the readiness level of health professionals for implementing an EMR system.

Keep it simple: designing a user-centred digital information system to support chronic disease management in low/middle-income countries

OBJECTIVE

Implement a user-centred digital health information system to facilitate rapidly and substantially increasing the number of patients treated for hypertension in low/middle-income countries.

METHODS

User-centred design of Simple, an offline-first app for mobile devices to record patient clinical visits and a web-based dashboard to monitor programme performance.

RESULTS

The Simple mobile application scaled rapidly over the past 4 years to reach more than 11 400 primary care facilities in four countries with over 3 million patients enrolled. Simple achieved median duration for new patient registration of 76 s (IQR 2 s) and follow-up visit entry of 13 s (IQR 1 s).

CONCLUSIONS

A fast, easy-to-use digital information system for hypertension programmes that accommodates healthcare worker time constraints by minimising data entry and focusing on key performance indicators can successfully reach scale in low-resource settings.

Small area population denominators for improved disease surveillance and response

The Covid-19 pandemic has highlighted the value of strong surveillance systems in supporting our abilities to respond rapidly and effectively in mitigating the impacts of infectious diseases. A cornerstone of such systems is basic subnational scale data on populations and their demographics, which enable the scale of outbreaks to be assessed, risk to specific groups to be determined and appropriate interventions to be designed. Ongoing weaknesses and gaps in such data have however been highlighted by the pandemic. These can include outdated or inaccurate census data and a lack of administrative and registry systems to update numbers, particularly in low and middle income settings. Efforts to design and implement globally consistent geospatial modelling methods for the production of small area demographic data that can be flexibly integrated into health-focussed surveillance and information systems have been made, but these often remain based on outdated population data or uncertain projections. In recent years, efforts have been made to capitalise on advances in computing power, satellite imagery and new forms of digital data to construct methods for estimating small area population distributions across national and regional scales in the absence of full enumeration. These are starting to be used to complement more traditional data collection approaches, especially in the delivery of health interventions, but barriers remain to their widespread adoption and use in disease surveillance and response. Here an overview of these approaches is presented, together with discussion of future directions and needs.

Production and Provision of Context-Based Patient-Specific Educational Resources

BACKGROUND

Patient education is generally accompanied by instructive materials. The Korean government has recommended the provision of patient-specific educational materials (PEMs) via an electronic medical record (EMR) certification system. However, there are currently no clear standards or guidelines for including PEMs in current domestic educational materials. We investigated the benefits of integrating PEMs with the EMR certification system and the methods by which this integration can be achieved.

METHODS

We developed and administered three structured Delphi surveys to 26 healthcare providers in clinical settings based on data collected from separate semi-structured advisory interviews with five experts. The surveys included the following topics: 1) expected effects of patient-specific education and health-related notifications/alarms, 2) desirable methods for providing PEMs, and 3) appropriate fee-setting and government support. We distributed the Delphi surveys via e-mail and calculated the average and standard deviation of the survey responses.

RESULTS

PEMs are expected to have significant educational effects, such as the provision of surgery/intervention-related information, and will improve the understanding of various treatment processes/procedures. The preferred method for providing PEMs was via automatic request after receiving confirmation from healthcare providers. The provision of these materials was based on set fees and government support. The average fee per session was set at approximately USD 23 (as of October 2021, USD 1 = KRW 1,196).

CONCLUSION

In this study, we investigated the prerequisites, contents, methods, and fees related to the provision of effective and efficient PEMs. The study findings can facilitate the production and provision of PEMs.

Health Information System in Developing Countries: A Review on the Challenges and Causes of Success and Failure

Background: A review on the health information systems (HISs) of each country should not be limited only to data collected and reported normally by the service providers. In this regard, the first step for the development in any national project is exploring the experiences of other countries worldwide, especially those with economic, political, cultural, and regional partnerships, and then using their resources and documents to have a broader attitude and a better profitability in planning the development strategy. This study was conducted to review the studies conducted on the causes of HIS success and failure, and the challenges faced by developing countries in using these systems. Methods: The present study was a narrative review to meet the aim of the study, and those studies published in English language in PubMed, Web of science, and Science Direct databases and Scopus between 2000 and 2020 were investigated. Primary keywords used to extract content in these databases were as follows: "health information system", "challenges", "success", "failure", "developing country", and "low and middle income country". Results: After searching the above-mentioned databases, 455 studies were retrieved. Finally, 24 articles were used. The causes of success and failure of HISs were finally divided into 4 categories: human, organizational, financial and technical factors. A total of 30 subfactors were extracted for different factors. Moreover, the findings indicated that many of the challenges that developing countries face in using HISs are influenced by the social, cultural, economic, geographical, and political conditions of these countries. The results represented that organizational and human elements play a critical role in the advancement or falling of the health HIS in growing countries. Conclusion: There is a demand to come up with flexible standards for designing and deploying HISs to address these complexities. Several solutions can be found to address the obstacles and problems facing HISs in developing countries, including formulating strategic plans and policies necessary for the development of national HISs.

A Formal Model for the FAIR4Health Information Architecture

In the EU project FAIR4Health, a ETL pipeline for the FAIRification of structured health data as well as an agent-based, distributed query platform for the analysis of research hypotheses and the training of machine learning models were developed. The system has been successfully tested in two clinical use cases with patient data from five university hospitals. Currently, the solution is also being considered for use in other hospitals. However, configuring the system and deploying it in the local IT architecture is non-trivial and meets with understandable concerns about security. This paper presents a model for describing the information architecture based on a formal approach, the 3LGM metamodel. The model was evaluated by the developers. As a result, the clear separation of tasks and the software components that implement them as well as the rich description of interactions via interfaces were positively emphasized.

Improving Findability of Digital Assets in Research Data Repositories Using the W3C DCAT Vocabulary

Research data management requires stable, trustworthy repositories to safeguard scientific research results. In this context, rich markup with metadata is crucial for the discoverability and interpretability of the relevant resources. SEEK is a web-based software to manage all important artifacts of a research project, including project structures, involved actors, documents and datasets. SEEK is organized along the ISA model (Investigation - Study - Assay). It offers several machine-readable serializations, including JSON and RDF. In this paper, we extend the power of RDF serialization by leveraging the W3C Data Catalog Vocabulary (DCAT). DCAT was specifically designed to improve interoperability between digital assets on the Web and enables cross-domain markup. By using community-consented gold standard vocabularies and a formal knowledge description language, findability and interoperability according to the FAIR principles are significantly improved.

Health Information Systems Adaptation and Flexibility in Extreme Situations: The COVID Effect

In 2020, a pandemic forced the entire world to adapt to a new scenario. The objective of this study was to know how Health Information Systems were adapted driven by the pandemic of COVID. 12 CIOS of healthcare organizations were interviewed and the interviews were classified according to the dimensions of a sociotechnical model: Infrastructure, Clinical Content, Human Computer Interface, People, Workflow and Communication, Organizational Characteristics and Internal Policies, Regulations, and Measurement and Monitoring. Adaptation to the Pandemic involved social, organizational and cultural rather than merely technical aspects in private organizations with mature and stable Health Information Systems.

Establishing a Data Quality Baseline in the AKTIN Emergency Department Data Registry - A Secondary Use Perspective

Secondary use of clinical data is an increasing application that is affected by the data quality (DQ) of its source systems. Techniques such as audits and risk-based monitoring for controlling DQ often rely on source data verification (SDV). SDV requires access to data generating systems. We present an approach to a targeted SDV based on manual input and synthetic data that is applicable in low resource settings with restricted system access. We deployed the protocol in the DQ management of the AKTIN Emergency Department Data Registry. Our targeted approach has shown to be feasible to form a DQ baseline that can be used for different DQ monitoring processes such as the identification of different error sources.

Feasibility of establishing a core set of sexual, reproductive, maternal, newborn, child, and adolescent health indicators in humanitarian settings: results from a multi-methods assessment in Bangladesh

BACKGROUND

Reliable and rigorously collected sexual, reproductive, maternal, newborn, child, and adolescent health (SRMNCAH) data in humanitarian settings is often sparse and varies in quality across different humanitarian settings. To address this gap in quality data, the World Health Organization (WHO) developed a core set of indicators for monitoring and evaluating SRMNCAH services and outcomes, and assessed their feasibility in Bangladesh, Afghanistan, Jordan, and the Democratic Republic of Congo.

METHODS

The feasibility assessments aggregated information from global consultations and field-level assessments to reach a consensus on a set of core SRMNCAH indicators among WHO partners. The feasibility assessment in Bangladesh focused on the following constructs: relevance/usefulness of the core set of indicators, the feasibility of measurement, availability of systems and resources, and ethical issues during data collection and management. The field-level multi-methods assessment included five components; a desk review, key informant interviews, focus group discussions, and facility assessments including observations of facility-level data management.

RESULTS

The findings suggest that there is widespread support among stakeholders for developing a standardized core set of SRMNCAH indicators to be collected among all humanitarian actors in Bangladesh. There are numerous resources and data collection systems that could be leveraged, built upon, and improved to ensure the feasibility of collecting this proposed set of indicators. However, the data collection load requested from donors, the national government, international and UN agencies, coordination/cluster systems must be better harmonized, standardized, and less burdensome.

CONCLUSION

This core set of indicators would only be useful if it has the buy-in from the international community that results in harmonizing and coordinating data collection efforts and relevant indicators' reporting requirements.