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Tecchio P, Gentilin A. TG Vascutrack: A User-Friendly and Open-Source Software for Automated Extraction of Arterial Diameter and Velocity Profile Data From Vascular Ultrasound Videos. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:2203-2211. [PMID: 39162227 DOI: 10.1002/jum.16553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 07/05/2024] [Accepted: 08/03/2024] [Indexed: 08/21/2024]
Abstract
Existing automated software for vascular ultrasound data extraction lacks free, open-source options suitable for professionals without coding experience. These programs typically include signal-cleaning algorithms, resulting in processed output without access to raw data. To address these needs, we developed TG Vascutrack, an open-source and user-friendly software tailored for non-coder professionals. It features a graphical interface, multiple functionalities, and provides access to raw data. Comparative analysis against validated software and manual extraction revealed minimal biases and standard deviations in diameter and velocity measurements. TG Vascutrack offers a free, promising solution for non-coders needing automated vascular ultrasound data extraction.
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Affiliation(s)
- Paolo Tecchio
- Human Movement Science, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
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2
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Bonacin R, de Figueiredo EB, de Franco Rosa F, Dos Reis JC, Dametto M. The reuse of electronic health records information models in the oncology domain: Studies with the bioframe framework. J Biomed Inform 2024; 157:104704. [PMID: 39127228 DOI: 10.1016/j.jbi.2024.104704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/12/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVE The reuse of Electronic Health Records (EHR) information models (e.g., templates and archetypes) may bring various benefits, including higher standardization, integration, interoperability, increased productivity in developing EHR systems, and unlock potential Artificial Intelligence applications built on top of medical records. The literature presents recent advances in standards for modeling EHR, in Knowledge Organization Systems (KOS) and EHR data reuse. However, methods, development processes, and frameworks to improve the reuse of EHR information models are still scarce. This study proposes a software engineering framework, named BioFrame, and analyzes how the reuse of EHR information models can be improved during the development of EHR systems. METHODS EHR standards and KOS, including ontologies, identified from systematic reviews were considered in developing the BioFrame framework. We used the structure of the OpenEHR to model templates and archetypes, as well as its relationship to international KOS used in the oncology domain. Our framework was applied in the context of pediatric oncology. Three data entry forms concerning nutrition and one utilized during the first pediatric oncology consultations were analyzed to measure the reuse of information models. RESULTS There was an increase in the adherence rate to international KOS of 18% to the original forms. There was an increase in the concepts reused in all 12 scenarios analyzed, with an average reuse of 6.55% in the original forms compared to 17.1% using BioFrame, resulting in significant differences. CONCLUSIONS Our results point to higher reuse rates achieved due to an engineering process that provided greater adherence to EHR standards combined with semantic artifacts. This reveals the potential to develop new methods and frameworks aimed at EHR information model reuse. Additional research is needed to evaluate the impacts of the reuse of the EHR information model on interoperability, EHR data reuse, and data quality and assess the proposed framework in other health domains.
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Affiliation(s)
- Rodrigo Bonacin
- CTI Renato Archer and UNIFACCAMP, Rod. D. Pedro I, km 143, Campinas, 13069-901, SP, Brazil.
| | | | | | - Julio Cesar Dos Reis
- Institute of Computing - University of Campinas, Av. Albert Einstein, 1251, Campinas, 13083-852, SP, Brazil
| | - Mariangela Dametto
- CTI Renato Archer and UNIFACCAMP, Rod. D. Pedro I, km 143, Campinas, 13069-901, SP, Brazil
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Gentilin A. Open-source synthetic photoplethysmographic signal generator with analog output. Proc Inst Mech Eng H 2024; 238:928-935. [PMID: 39127880 DOI: 10.1177/09544119241272833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
The photoplethysmographic (PPG) signal of the finger is being used to create embedded devices that estimate physiological variables. This project outlines an innovative method for developing a synthetic PPG generator that produces both actual reference digital signals and their equivalent analog signals using open-source technology. A series of PPG profiles is synthesized using three variant Gaussian functions. A low-frequency trend induced by respiratory frequency and background noise are then added. To generate a diverse range of continuously variable PPG profiles within specified boundaries and customizable levels of interference, all parameters undergo random fluctuations on a cycle-by-cycle basis, as per user-defined constraints. The generated signal is then converted into its equivalent analog form through the use of an RC filter that low-frequency filters a Pulse-Width Modulation square wave that is modulated directly by the generated signal. The software returns different PPG profiles and allows the signal comparison before vs after the addition of different-intensity modulated respiratory trends and background noise. The digital signal is faithfully converted into an equivalent analog voltage signal capable of reproducing not only the waveform profile but also the respiratory trend and various levels of noise.
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Bostan S, Johnson OA, Jaspersen LJ, Randell R. Contextual Barriers to Implementing Open-Source Electronic Health Record Systems for Low- and Lower-Middle-Income Countries: Scoping Review. J Med Internet Res 2024; 26:e45242. [PMID: 39088815 PMCID: PMC11327637 DOI: 10.2196/45242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 09/29/2023] [Accepted: 02/09/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND Low- and lower-middle-income countries account for a higher percentage of global epidemics and chronic diseases. In most low- and lower-middle-income countries, there is limited access to health care. The implementation of open-source electronic health records (EHRs) can be understood as a powerful enabler for low- and lower-middle-income countries because it can transform the way health care technology is delivered. Open-source EHRs can enhance health care delivery in low- and lower-middle-income countries by improving the collection, management, and analysis of health data needed to inform health care delivery, policy, and planning. While open-source EHR systems are cost-effective and adaptable, they have not proliferated rapidly in low- and lower-middle-income countries. Implementation barriers slow adoption, with existing research focusing predominantly on technical issues preventing successful implementation. OBJECTIVE This interdisciplinary scoping review aims to provide an overview of contextual barriers affecting the adaptation and implementation of open-source EHR systems in low- and lower-middle-income countries and to identify areas for future research. METHODS We conducted a scoping literature review following a systematic methodological framework. A total of 7 databases were selected from 3 disciplines: medicine and health sciences, computing, and social sciences. The findings were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. The Mixed Methods Appraisal Tool and the Critical Appraisal Skills Programme checklists were used to assess the quality of relevant studies. Data were collated and summarized, and results were reported qualitatively, adopting a narrative synthesis approach. RESULTS This review included 13 studies that examined open-source EHRs' adaptation and implementation in low- and lower-middle-income countries from 3 interrelated perspectives: socioenvironmental, technological, and organizational barriers. The studies identified key issues such as limited funding, sustainability, organizational and management challenges, infrastructure, data privacy and protection, and ownership. Data protection, confidentiality, ownership, and ethics emerged as important issues, often overshadowed by technical processes. CONCLUSIONS While open-source EHRs have the potential to enhance health care delivery in low- and lower-middle-income-country settings, implementation is fraught with difficulty. This scoping review shows that depending on the adopted perspective to implementation, different implementation barriers come into view. A dominant focus on technology distracts from socioenvironmental and organizational barriers impacting the proliferation of open-source EHRs. The role of local implementing organizations in addressing implementation barriers in low- and lower-middle-income countries remains unclear. A holistic understanding of implementers' experiences of implementation processes is needed. This could help characterize and solve implementation problems, including those related to ethics and the management of data protection. Nevertheless, this scoping review provides a meaningful contribution to the global health informatics discipline.
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Affiliation(s)
- Sarah Bostan
- Leeds University Business School, University of Leeds, Leeds, United Kingdom
- School of Healthcare, University of Leeds, Leeds, United Kingdom
- School of Computing, University of Leeds, Leeds, United Kingdom
| | - Owen A Johnson
- School of Computing, University of Leeds, Leeds, United Kingdom
| | - Lena J Jaspersen
- Leeds University Business School, University of Leeds, Leeds, United Kingdom
| | - Rebecca Randell
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
- Wolfson Centre for Applied Health Research, Bradford, United Kingdom
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Wosny M, Strasser LM, Hastings J. The Paradoxes of Digital Tools in Hospitals: Qualitative Interview Study. J Med Internet Res 2024; 26:e56095. [PMID: 39008341 PMCID: PMC11287097 DOI: 10.2196/56095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/21/2024] [Accepted: 04/16/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Digital tools are progressively reshaping the daily work of health care professionals (HCPs) in hospitals. While this transformation holds substantial promise, it leads to frustrating experiences, raising concerns about negative impacts on clinicians' well-being. OBJECTIVE The goal of this study was to comprehensively explore the lived experiences of HCPs navigating digital tools throughout their daily routines. METHODS Qualitative in-depth interviews with 52 HCPs representing 24 medical specialties across 14 hospitals in Switzerland were performed. RESULTS Inductive thematic analysis revealed 4 main themes: digital tool use, workflow and processes, HCPs' experience of care delivery, and digital transformation and management of change. Within these themes, 6 intriguing paradoxes emerged, and we hypothesized that these paradoxes might partly explain the persistence of the challenges facing hospital digitalization: the promise of efficiency and the reality of inefficiency, the shift from face to face to interface, juggling frustration and dedication, the illusion of information access and trust, the complexity and intersection of workflows and care paths, and the opportunities and challenges of shadow IT. CONCLUSIONS Our study highlights the central importance of acknowledging and considering the experiences of HCPs to support the transformation of health care technology and to avoid or mitigate any potential negative experiences that might arise from digitalization. The viewpoints of HCPs add relevant insights into long-standing informatics problems in health care and may suggest new strategies to follow when tackling future challenges.
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Affiliation(s)
- Marie Wosny
- School of Medicine, University of St Gallen, St.Gallen, Switzerland
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
| | | | - Janna Hastings
- School of Medicine, University of St Gallen, St.Gallen, Switzerland
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
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Moncy MM, Pilli M, Somasundaram M, Purkayastha S, Fulton CR. Evaluation of accessibility of open-source EHRs for visually impaired users. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2024; 2023:1165-1174. [PMID: 38222344 PMCID: PMC10785889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
This study investigates the accessibility of open-source electronic health record (EHR) systems for individuals who are visually impaired or blind. Ensuring the accessibility of EHRs to visually impaired users is critical for the diversity, equity, and inclusion of all users. The study used a combination of automated and manual accessibility testing with screen readers to evaluate the accessibility of three widely used open-source EHR systems. We used three popular screen readers - JAWS (Windows), NVDA (Windows), and Apple VoiceOver (OSX) to evaluate accessibility. The evaluation revealed that although each of the three EHR systems was partially accessible, there is room for improvement, particularly regarding keyboard navigation and screen reader compatibility. The study concludes with recommendations for making EHR systems more inclusive for all users and more accessible.
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Affiliation(s)
- Megha M Moncy
- Dept. of BioHealth Informatics, Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Manya Pilli
- Dept. of BioHealth Informatics, Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Manasi Somasundaram
- Dept. of BioHealth Informatics, Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Saptarshi Purkayastha
- Dept. of BioHealth Informatics, Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Cathy R Fulton
- Dept. of BioHealth Informatics, Indiana University Purdue University Indianapolis, Indianapolis, IN
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Bucher SL, Young A, Dolan M, Padmanaban GP, Chandnani K, Purkayastha S. The NeoRoo mobile app: Initial design and prototyping of an Android-based digital health tool to support Kangaroo Mother Care in low/middle-income countries (LMICs). PLOS DIGITAL HEALTH 2023; 2:e0000216. [PMID: 37878575 PMCID: PMC10599536 DOI: 10.1371/journal.pdig.0000216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/12/2023] [Indexed: 10/27/2023]
Abstract
Premature birth and neonatal mortality are significant global health challenges, with 15 million premature births annually and an estimated 2.5 million neonatal deaths. Approximately 90% of preterm births occur in low/middle income countries, particularly within the global regions of sub-Saharan Africa and South Asia. Neonatal hypothermia is a common and significant cause of morbidity and mortality among premature and low birth weight infants, particularly in low/middle-income countries where rates of premature delivery are high, and access to health workers, medical commodities, and other resources is limited. Kangaroo Mother Care/Skin-to-Skin care has been shown to significantly reduce the incidence of neonatal hypothermia and improve survival rates among premature infants, but there are significant barriers to its implementation, especially in low/middle-income countries (LMICs). The paper proposes the use of a multidisciplinary approach to develop an integrated mHealth solution to overcome the barriers and challenges to the implementation of Kangaroo Mother Care/Skin-to-skin care (KMC/STS) in LMICs. The innovation is an integrated mHealth platform that features a wearable biomedical device (NeoWarm) and an Android-based mobile application (NeoRoo) with customized user interfaces that are targeted specifically to parents/family stakeholders and healthcare providers, respectively. This publication describes the iterative, human-centered design and participatory development of a high-fidelity prototype of the NeoRoo mobile application. The aim of this study was to design and develop an initial ("A") version of the Android-based NeoRoo mobile app specifically to support the use case of KMC/STS in health facilities in Kenya. Key functions and features are highlighted. The proposed solution leverages the promise of digital health to overcome identified barriers and challenges to the implementation of KMC/STS in LMICs and aims to equip parents and healthcare providers of prematurely born infants with the tools and resources needed to improve the care provided to premature and low birthweight babies. It is hoped that, when implemented and scaled as part of a thoughtful, strategic, cross-disciplinary approach to reduction of global rates of neonatal mortality, NeoRoo will prove to be a useful tool within the toolkit of parents, health workers, and program implementors.
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Affiliation(s)
- Sherri Lynn Bucher
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
- Department of Community and Global Health, Richard M. Fairbanks School of Public Health, Indiana University–Indianapolis, Indianapolis, Indiana, United States of America
| | - Allison Young
- Scholarly Concentration in Public Health Certificate Program, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Indiana University–Indianapolis, Indianapolis, Indiana, United States of America
| | - Madison Dolan
- Scholarly Concentration in Public Health Certificate Program, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Indiana University–Indianapolis, Indianapolis, Indiana, United States of America
| | - Geetha Priya Padmanaban
- Department of Human Centered Computing, Human-Computer Interaction, Luddy School of Informatics, Computing, and Engineering, Indiana University–Indianapolis, Indianapolis, Indiana, United States of America
| | - Khushboo Chandnani
- Department of Human Centered Computing, Human-Computer Interaction, Luddy School of Informatics, Computing, and Engineering, Indiana University–Indianapolis, Indianapolis, Indiana, United States of America
| | - Saptarshi Purkayastha
- Department of BioHealth Informatics, Data Science and Health Informatics, Luddy School of Informatics, Computing, and Engineering, Indiana University–Indianapolis, Indianapolis, Indiana, United States of America
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Peplinski JE, Pearce JM. Economic Efficiency of an Open-Source National Medical Lab Software in Canada. J Med Syst 2023; 47:50. [PMID: 37081312 PMCID: PMC10119013 DOI: 10.1007/s10916-023-01949-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 04/15/2023] [Indexed: 04/22/2023]
Abstract
Although the Canada federal government has invested over $3.1 billion developing health information technology (HIT), all 10 provinces still have their own separate HIT systems, which are non-interoperable, expensive, and inconsistent. After first reviewing how these systems operate, this paper analyzes the costs and savings of integrating the common billing, lab results, and diagnostic imaging (BLD) functions of these separate systems using free and open-source software and proposes a system for this, HermesAPI. Currently, 8 provincial governments representing over 95% of Canada's population allow private companies to create their own electronic medical records (EMR) system and integrate with provincial BLD systems. This study found the cost to develop and maintain HermesAPI would be between CAD$610,000 to CAD$740,000, but would prevent CAD$120,000 per company per province in development costs for a total savings of $6.4 million. HermesAPI would lower barriers to entry for the HIT industry to increase competition, improve the quality of HIT products, and ultimately patient care. The proposed open-source approach of the HermesAPI is one option towards building a more interoperable, less expensive, and more consistent HIT system for Canada.
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Affiliation(s)
- Jack E. Peplinski
- Department of Electrical and Computer Engineering and Ivey Business School, Western University, London, ON Canada
| | - Joshua M. Pearce
- Department of Electrical and Computer Engineering and Ivey Business School, Western University, London, ON Canada
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Sinaci AA, Gencturk M, Teoman HA, Laleci Erturkmen GB, Alvarez-Romero C, Martinez-Garcia A, Poblador-Plou B, Carmona-Pírez J, Löbe M, Parra-Calderon CL. A Data Transformation Methodology to Create Findable, Accessible, Interoperable, and Reusable Health Data: Software Design, Development, and Evaluation Study. J Med Internet Res 2023; 25:e42822. [PMID: 36884270 PMCID: PMC10034606 DOI: 10.2196/42822] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/04/2023] [Accepted: 01/31/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Sharing health data is challenging because of several technical, ethical, and regulatory issues. The Findable, Accessible, Interoperable, and Reusable (FAIR) guiding principles have been conceptualized to enable data interoperability. Many studies provide implementation guidelines, assessment metrics, and software to achieve FAIR-compliant data, especially for health data sets. Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) is a health data content modeling and exchange standard. OBJECTIVE Our goal was to devise a new methodology to extract, transform, and load existing health data sets into HL7 FHIR repositories in line with FAIR principles, develop a Data Curation Tool to implement the methodology, and evaluate it on health data sets from 2 different but complementary institutions. We aimed to increase the level of compliance with FAIR principles of existing health data sets through standardization and facilitate health data sharing by eliminating the associated technical barriers. METHODS Our approach automatically processes the capabilities of a given FHIR end point and directs the user while configuring mappings according to the rules enforced by FHIR profile definitions. Code system mappings can be configured for terminology translations through automatic use of FHIR resources. The validity of the created FHIR resources can be automatically checked, and the software does not allow invalid resources to be persisted. At each stage of our data transformation methodology, we used particular FHIR-based techniques so that the resulting data set could be evaluated as FAIR. We performed a data-centric evaluation of our methodology on health data sets from 2 different institutions. RESULTS Through an intuitive graphical user interface, users are prompted to configure the mappings into FHIR resource types with respect to the restrictions of selected profiles. Once the mappings are developed, our approach can syntactically and semantically transform existing health data sets into HL7 FHIR without loss of data utility according to our privacy-concerned criteria. In addition to the mapped resource types, behind the scenes, we create additional FHIR resources to satisfy several FAIR criteria. According to the data maturity indicators and evaluation methods of the FAIR Data Maturity Model, we achieved the maximum level (level 5) for being Findable, Accessible, and Interoperable and level 3 for being Reusable. CONCLUSIONS We developed and extensively evaluated our data transformation approach to unlock the value of existing health data residing in disparate data silos to make them available for sharing according to the FAIR principles. We showed that our method can successfully transform existing health data sets into HL7 FHIR without loss of data utility, and the result is FAIR in terms of the FAIR Data Maturity Model. We support institutional migration to HL7 FHIR, which not only leads to FAIR data sharing but also eases the integration with different research networks.
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Affiliation(s)
- A Anil Sinaci
- Software Research & Development and Consultancy Corporation (SRDC), Cankaya, Turkey
| | - Mert Gencturk
- Software Research & Development and Consultancy Corporation (SRDC), Cankaya, Turkey
- Department of Computer Engineering, Middle East Technical University, Cankaya, Turkey
| | - Huseyin Alper Teoman
- Software Research & Development and Consultancy Corporation (SRDC), Cankaya, Turkey
- Department of Computer Engineering, Middle East Technical University, Cankaya, Turkey
| | | | - Celia Alvarez-Romero
- Group of Computational Health Informatics, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Spanish National Research Council, University of Seville, Seville, Spain
| | - Alicia Martinez-Garcia
- Group of Computational Health Informatics, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Spanish National Research Council, University of Seville, Seville, Spain
| | - Beatriz Poblador-Plou
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - Jonás Carmona-Pírez
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - Matthias Löbe
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Carlos Luis Parra-Calderon
- Group of Computational Health Informatics, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Spanish National Research Council, University of Seville, Seville, Spain
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Lovis C, Ammenwerth E, Dornauer V, Höffner K, Bindel M, Karopka T, Winter A. A Linked Open Data-Based Terminology to Describe Libre/Free and Open-source Software: Incremental Development Study. JMIR Med Inform 2023; 11:e38861. [PMID: 36662569 PMCID: PMC9898829 DOI: 10.2196/38861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/28/2022] [Accepted: 11/09/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND There is a variety of libre/free and open-source software (LIFOSS) products for medicine and health care. To support health care and IT professionals select an appropriate software product for given tasks, several comparison studies and web platforms, such as Medfloss.org, are available. However, due to the lack of a uniform terminology for health informatics, ambiguous or imprecise terms are used to describe the functionalities of LIFOSS. This makes comparisons of LIFOSS difficult and may lead to inappropriate software selection decisions. Using Linked Open Data (LOD) promises to address these challenges. OBJECTIVE We describe LIFOSS systematically with the help of the underlying Health Information Technology Ontology (HITO). We publish HITO and HITO-based software product descriptions using LOD to obtain the following benefits: (1) linking and reusing existing terminologies and (2) using Semantic Web tools for viewing and querying the LIFOSS data on the World Wide Web. METHODS HITO was incrementally developed and implemented. First, classes for the description of software products in health IT evaluation studies were identified. Second, requirements for describing LIFOSS were elicited by interviewing domain experts. Third, to describe domain-specific functionalities of software products, existing catalogues of features and enterprise functions were analyzed and integrated into the HITO knowledge base. As a proof of concept, HITO was used to describe 25 LIFOSS products. RESULTS HITO provides a defined set of classes and their relationships to describe LIFOSS in medicine and health care. With the help of linked or integrated catalogues for languages, programming languages, licenses, features, and enterprise functions, the functionalities of LIFOSS can be precisely described and compared. We publish HITO and the LIFOSS descriptions as LOD; they can be queried and viewed using different Semantic Web tools, such as Resource Description Framework (RDF) browsers, SPARQL Protocol and RDF Query Language (SPARQL) queries, and faceted searches. The advantages of providing HITO as LOD are demonstrated by practical examples. CONCLUSIONS HITO is a building block to achieving unambiguous communication among health IT professionals and researchers. Providing LIFOSS product information as LOD enables barrier-free and easy access to data that are often hidden in user manuals of software products or are not available at all. Efforts to establish a unique terminology of medical and health informatics should be further supported and continued.
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Affiliation(s)
| | - Elske Ammenwerth
- Institute of Medical Informatics, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Verena Dornauer
- Institute of Medical Informatics, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Konrad Höffner
- Institute of Medical Informatics, Statistics and Epidemiology, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Michelle Bindel
- Institute of Medical Informatics, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | | | - Alfred Winter
- Institute of Medical Informatics, Statistics and Epidemiology, Faculty of Medicine, Leipzig University, Leipzig, Germany
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Improving child health through Big Data and data science. Pediatr Res 2023; 93:342-349. [PMID: 35974162 PMCID: PMC9380977 DOI: 10.1038/s41390-022-02264-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/10/2022] [Accepted: 06/28/2022] [Indexed: 12/04/2022]
Abstract
Child health is defined by a complex, dynamic network of genetic, cultural, nutritional, infectious, and environmental determinants at distinct, developmentally determined epochs from preconception to adolescence. This network shapes the future of children, susceptibilities to adult diseases, and individual child health outcomes. Evolution selects characteristics during fetal life, infancy, childhood, and adolescence that adapt to predictable and unpredictable exposures/stresses by creating alternative developmental phenotype trajectories. While child health has improved in the United States and globally over the past 30 years, continued improvement requires access to data that fully represent the complexity of these interactions and to new analytic methods. Big Data and innovative data science methods provide tools to integrate multiple data dimensions for description of best clinical, predictive, and preventive practices, for reducing racial disparities in child health outcomes, for inclusion of patient and family input in medical assessments, and for defining individual disease risk, mechanisms, and therapies. However, leveraging these resources will require new strategies that intentionally address institutional, ethical, regulatory, cultural, technical, and systemic barriers as well as developing partnerships with children and families from diverse backgrounds that acknowledge historical sources of mistrust. We highlight existing pediatric Big Data initiatives and identify areas of future research. IMPACT: Big Data and data science can improve child health. This review highlights the importance for child health of child-specific and life course-based Big Data and data science strategies. This review provides recommendations for future pediatric-specific Big Data and data science research.
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NTD Health: an electronic medical record system for neglected tropical diseases. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2022; 42:602-610. [PMID: 36511677 PMCID: PMC9788840 DOI: 10.7705/biomedica.6269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The use of technological resources to support processes in health systems has generated robust, interoperable and dynamic platforms. In the case of institutions working with neglected tropical diseases (NTD), there is a need for NTD-specific customizations. OBJECTIVES To establish a medical records platform, specialized for NTD, which would facilitate the analysis of treatment evolution in patients, as well as generate more accurate data about various clinical aspects. MATERIALS AND METHODS Here we developed a customized electronic medical record system based on OpenMRS for multiple NTDs. A set of forms and functionalities was developed under the OpenMRS guidelines, using shared community modules. RESULTS All the customized information was packaged in a distribution called NTD Health. The platform is web-based and can be upgraded and improved by users without technological barriers. CONCLUSIONS The EMR system can become a useful tool for other institutions to improve their health practices as well as the quality of life for NTD patients, simplifying the customization of healthcare systems able to interoperate with other platforms.
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Vezertzis K, Lambrou GI, Koutsouris D. Design and Virtual Workflow of a Patient Database for Clinical and Pharmaceutical Trials Part II: A Prototype for Endocrinology. Cureus 2022; 14:e30006. [PMID: 36348829 PMCID: PMC9637329 DOI: 10.7759/cureus.30006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 01/24/2023] Open
Abstract
Background In previous work, we have reported that patient recruitment is closely related to electronic health records (EHR). As a result, the next step of investigation would lead to the implementation of research practices for using EHR in selecting patients for clinical trials. Towards that end, open-source software offers several integrated solutions that can meet the needs of an EHR and patient recruitment. Aim In the present work, we have designed a prototype of a patient recruitment system using open-source tools. The proposed prototype can draw data from a patient management system and present selected patients based on specific criteria. Methods For the objective of the present study, we have used the methodology described previously. In particular, we recorded numerous integrated solutions for EHR from the area of free and open-source software. Open Electronic Medical Records (OpenEMR) ranked first for functionality and second for usability efficiency. Hence, we relied on OpenEMR to design a prototype patient recruitment system. After the installation and commissioning of OpenEMR, we created appropriate test scenarios. Therefore, populated appropriate patient data in OpenEMR. PhpMyAdmin was installed and commissioned along with the OpenEMR installation. This tool is used to manage MySQL database systems. MySQL is the database system that programmers rely on to develop OpenEMR. Results A prototype patient recruitment system was designed, which draws data from a view of the OpenEMR database to present results based on criteria. Conclusions After the adaptation of the database and the design of the proposed solution, we concluded, based on the prototype results, that there is potential for developing an integrated patient recruitment management system. This management system can be based on the implementation of complex criteria and present results according to the needs of the end-user.
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Affiliation(s)
| | - George I Lambrou
- Laboratory for the Research of Musculoskeletal Disorders, National and Kapodistrian University of Athens, Athens, GRC
- First Department of Pediatrics, Choremeio Research Laboratory, National and Kapodistrian University of Athens, Athens, GRC
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens, GRC
| | - Dimitrios Koutsouris
- Biomedical Engineering Laboratory, National Technical University of Athens, Athens, GRC
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Shaikh M, Vayani AH, Akram S, Qamar N. Open-source electronic health record systems: A systematic review of most recent advances. Health Informatics J 2022; 28:14604582221099828. [PMID: 35588400 DOI: 10.1177/14604582221099828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Open-source Electronic Health Records (OS-EHRs) are of pivotal importance in the management, operations, and administration of any healthcare organization. With the advancement of health informatics, researchers and healthcare practitioners have proposed various frameworks to assess the maturation of Open-source EHRs. The significance of OS-EHRs stems from the fact that vendor-based EHR implementations are becoming financially burdensome, with some vendors raking in more than $1 billion with one contract. Contrarily, the adoption of OS-EHRs suffers from a lack of systematic evaluation from the standpoint of a standard reference model. To this end, the Healthcare Information and Management Systems Society (HIMSS) has presented a strategic road map called EMR Adoption and Maturity (EMRAM). The HIMSS-EMRAM model proposes a stage-wise model approach that is globally recognized and can be essentially applied as a benchmark evaluation criteria for open-source EHRs. This paper offers an applied descriptive methodology over the frequently studied open-source EHRs currently operational worldwide or has the potential of adoption in healthcare settings. Besides, we also present profiling (User Support, Developer' Support, Customization Support, Technical details, and Diagnostic help) of studied OS-EHRs from developer's and user's perspectives using updated standard metrics. We carried out multi-aspect objective analysis of studied systems covering EHR functions, software based features and implementation. This review portrays systematic aspects of electronic medical record standards for open-source software implementations. As we observed in the literature, prevalent research and working prototypes lack systematic review of the HIMSS-EMRAM model and do not present evolving software features. Therefore, after the application of our assessment measures, the results obtained indicate that OS-EHRs are yet to acquire standard compliance and implementation. The findings in this paper can be beneficial in the planning and implementation of OS-EHRs projects in the future.
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Affiliation(s)
- Mohsin Shaikh
- Department of Computer Science, Quaid-e-Awam University of Engineering Science and Technology, Nawabshah, Pakistan
| | | | - Sabina Akram
- FAST National University of Computer and Emerging Sciences, Islamabad, Pakistan
| | - Nafees Qamar
- College of Health and Human Services, Governors State University, University Park, IL, University Park, USA
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Adedeji T, Fraser H, Scott P. Implementing Electronic Health Records in Primary Care Using the Theory of Change: A Nigerian Case Study (Preprint). JMIR Med Inform 2021; 10:e33491. [PMID: 35969461 PMCID: PMC9412900 DOI: 10.2196/33491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/25/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Taiwo Adedeji
- School of Computing, University of Portsmouth, Portsmouth, United Kingdom
| | - Hamish Fraser
- Brown Center for Biomedical Informatics, Brown University, Providence, RI, United States
| | - Philip Scott
- Institute of Management and Health, University of Wales Trinity Saint David, Carmarthen, United Kingdom
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Abstract
While efforts are underway to create a sound system of electronic health records in Palestinian health institutions, there remain obstacles and challenges. Given modern day demands on health systems, we propose a federated electronic health system based on the clinical document architecture (CDA) that is compliant within the Palestine context. This architecture also brings a normalized electronic health record and a structure of blockchain to enhance interoperability with scalability, fault tolerance, privacy, and security. The new architecture and technologies will enhance services by allowing health care players, patients, and others to have the opportunity to obtain improved access and control of their health services. This may also serve as a useful model for other low-middle income countries.
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