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Yigzaw KY, Chomutare T, Wynn R, Berntsen GKR, Bellika JG. A Privacy-Preserving Audit and Feedback System for the Antibiotic Prescribing of General Practitioners: Survey Study. JMIR Form Res 2022; 6:e31650. [PMID: 35830221 PMCID: PMC9330202 DOI: 10.2196/31650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 03/21/2022] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Antibiotic resistance is a worldwide public health problem that is accelerated by the misuse and overuse of antibiotics. Studies have shown that audits and feedback enable clinicians to compare their personal clinical performance with that of their peers and are effective in reducing the inappropriate prescribing of antibiotics. However, privacy concerns make audits and feedback hard to implement in clinical settings. To solve this problem, we developed a privacy-preserving audit and feedback (A&F) system. Objective This study aims to evaluate a privacy-preserving A&F system in clinical settings. Methods A privacy-preserving A&F system was deployed at three primary care practices in Norway to generate feedback for 20 general practitioners (GPs) on their prescribing of antibiotics for selected respiratory tract infections. The GPs were asked to participate in a survey shortly after using the system. Results A total of 14 GPs responded to the questionnaire, representing a 70% (14/20) response rate. The participants were generally satisfied with the usefulness of the feedback and the comparisons with peers, as well as the protection of privacy. The majority of the GPs (9/14, 64%) valued the protection of their own privacy as well as that of their patients. Conclusions The system overcomes important privacy and scaling challenges that are commonly associated with the secondary use of electronic health record data and has the potential to improve antibiotic prescribing behavior; however, further study is required to assess its actual effect.
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Affiliation(s)
| | - Taridzo Chomutare
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Rolf Wynn
- Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Divison of Substance Use and Mental Health, University Hospital of North Norway, Tromsø, Norway
| | - Gro Karine Rosvold Berntsen
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Johan Gustav Bellika
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
- Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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2
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Kristoffersen ES, Bjorvatn B, Halvorsen PA, Nilsen S, Fossum GH, Fors EA, Jørgensen P, Øxnevad-Gundersen B, Gjelstad S, Bellika JG, Straand J, Rørtveit G. The Norwegian PraksisNett: a nationwide practice-based research network with a novel IT infrastructure. Scand J Prim Health Care 2022; 40:217-226. [PMID: 35549798 PMCID: PMC9397441 DOI: 10.1080/02813432.2022.2073966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
PURPOSE Clinical research in primary care is relatively scarce. Practice-based research networks (PBRNs) are research infrastructures to overcome hurdles associated with conducting studies in primary care. In Norway, almost all 5.4 million inhabitants have access to a general practitioner (GP) through a patient-list system. This gives opportunity for a PBRN with reliable information about the general population. The aim of the current paper is to describe the establishment, organization and function of PraksisNett (the Norwegian Primary Care Research Network). MATERIALS AND METHODS We describe the development, funding and logistics of PraksisNett as a nationwide PBRN. RESULTS PraksisNett received funding from the Research Council of Norway for an establishment period of five years (2018-2022). It is comprised of two parts; a human infrastructure (employees, including academic GPs) organized as four regional nodes and a coordinating node and an IT infrastructure comprised by the Snow system in conjunction with the Medrave M4 system. The core of the infrastructure is the 92 general practices that are contractually linked to PraksisNett. These include 492 GPs, serving almost 520,000 patients. Practices were recruited during 2019-2020 and comprise a representative mix of rural and urban settings spread throughout all regions of Norway. CONCLUSION Norway has established a nationwide PBRN to reduce hurdles for conducting clinical studies in primary care. Improved infrastructure for clinical studies in primary care is expected to increase the attractiveness for studies on the management of disorders and diseases in primary care and facilitate international research collaboration. This will benefit both patients, GPs and society in terms of improved quality of care.Key pointsPractice-based research networks (PBRNs) are research infrastructures to overcome hurdles associated with conducting studies in primary careImproved infrastructure for clinical studies in primary care is expected to increase the attractiveness for studies on the management of disorders and diseases in primary care and facilitate international research collaborationWe describe PraksisNett, a Norwegian PBRN consisting of 92 general practices including 492 GPs, serving almost 520,000 patientsAn advanced and secure IT infrastructure connects the general practices to PraksisNett and makes it possible to identify and recruit patients in a novel way, as well as reuse clinical dataPraksisNett will benefit both patients, GPs and society in terms of improved quality of careThis paper may inform and inspire initiatives to establish PBRNs elsewhere.
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Affiliation(s)
- Espen Saxhaug Kristoffersen
- Department of General Practice, HELSAM, University of Oslo, Oslo, Norway
- Research Unit for General Practice, Department of General Practice, HELSAM, University of Oslo, Oslo, Norway
- CONTACT Espen Saxhaug Kristoffersen Department of General Practice, HELSAM, University of Oslo, PO Box 1130, Blindern, Oslo0318, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Stein Nilsen
- Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway
| | - Guro Haugen Fossum
- Department of General Practice, HELSAM, University of Oslo, Oslo, Norway
- Research Unit for General Practice, Department of General Practice, HELSAM, University of Oslo, Oslo, Norway
| | - Egil A. Fors
- Research Unit for General Practice, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Pål Jørgensen
- Research Unit for General Practice, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | - Johan Gustav Bellika
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Jørund Straand
- Research Unit for General Practice, Department of General Practice, HELSAM, University of Oslo, Oslo, Norway
| | - Guri Rørtveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Smaradottir BF, Fagerlund AJ, Bellika JG. User-Centred Design of a Mobile Application for Chronic Pain Management. Stud Health Technol Inform 2020; 272:272-275. [PMID: 32604654 DOI: 10.3233/shti200547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Chronic pain patients constitute a large and heterogeneous patient group and it is important to build tools and methods that can identify efficient treatment options for each individual patient. It is estimated that 20-30% of the population has suffered from chronic pain and this imposes enormous costs on society and the national welfare programs. The research project Chronic Pain addresses the problem of how to provide patients and physicians with relevant, valid and adapted decision alternatives in a shared decision making tool. This paper presents the results from co-creation workshops early in the user-centred design process of the chronic pain mobile application. The end-users contributed in mapping the user needs and requirements, and made paper prototyping of the user interface. The main contribution lies on how a user-centred design methodology can be applied in a clinical development context.
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Affiliation(s)
- Berglind F Smaradottir
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.,Department of Information and Communication Technology, University of Agder, Grimstad, Norway
| | - Asbjørn J Fagerlund
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Johan Gustav Bellika
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
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4
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Yigzaw KY, Budrionis A, Marco-Ruiz L, Henriksen TD, Halvorsen PA, Bellika JG. Privacy-preserving architecture for providing feedback to clinicians on their clinical performance. BMC Med Inform Decis Mak 2020; 20:116. [PMID: 32571306 PMCID: PMC7310252 DOI: 10.1186/s12911-020-01147-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/03/2020] [Indexed: 11/13/2022] Open
Abstract
Background Learning from routine healthcare data is important for the improvement of the quality of care. Providing feedback on clinicians’ performance in comparison to their peers has been shown to be more efficient for quality improvements. However, the current methods for providing feedback do not fully address the privacy concerns of stakeholders. Methods The paper proposes a distributed architecture for providing feedback to clinicians on their clinical performances while protecting their privacy. The indicators for the clinical performance of a clinician are computed within a healthcare institution based on pseudonymized data extracted from the electronic health record (EHR) system. Group-level indicators of clinicians across healthcare institutions are computed using privacy-preserving distributed data-mining techniques. A clinician receives feedback reports that compare his or her personal indicators with the aggregated indicators of the individual’s peers. Indicators aggregated across different geographical levels are the basis for monitoring changes in the quality of care. The architecture feasibility was practically evaluated in three general practitioner (GP) offices in Norway that consist of about 20,245 patients. The architecture was applied for providing feedback reports to 21 GPs on their antibiotic prescriptions for selected respiratory tract infections (RTIs). Each GP received one feedback report that covered antibiotic prescriptions between 2015 and 2018, stratified yearly. We assessed the privacy protection and computation time of the architecture. Results Our evaluation indicates that the proposed architecture is feasible for practical use and protects the privacy of the patients, clinicians, and healthcare institutions. The architecture also maintains the physical access control of healthcare institutions over the patient data. We sent a single feedback report to each of the 21 GPs. A total of 14,396 cases were diagnosed with the selected RTIs during the study period across the institutions. Of these cases, 2924 (20.3%) were treated with antibiotics, where 40.8% (1194) of the antibiotic prescriptions were narrow-spectrum antibiotics. Conclusions It is feasible to provide feedback to clinicians on their clinical performance in comparison to peers across healthcare institutions while protecting privacy. The architecture also enables monitoring changes in the quality of care following interventions.
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Affiliation(s)
- Kassaye Yitbarek Yigzaw
- Norwegian Centre for E-health Research, University Hospital of North Norway, 9019, Tromsø, Norway.
| | - Andrius Budrionis
- Norwegian Centre for E-health Research, University Hospital of North Norway, 9019, Tromsø, Norway
| | - Luis Marco-Ruiz
- Norwegian Centre for E-health Research, University Hospital of North Norway, 9019, Tromsø, Norway
| | - Torje Dahle Henriksen
- Norwegian Centre for E-health Research, University Hospital of North Norway, 9019, Tromsø, Norway
| | - Peder A Halvorsen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Johan Gustav Bellika
- Norwegian Centre for E-health Research, University Hospital of North Norway, 9019, Tromsø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway
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5
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Wynn R, Oyeyemi SO, Budrionis A, Marco-Ruiz L, Yigzaw KY, Bellika JG. Electronic Health Use in a Representative Sample of 18,497 Respondents in Norway (The Seventh Tromsø Study - Part 1): Population-Based Questionnaire Study. JMIR Med Inform 2020; 8:e13106. [PMID: 32134395 PMCID: PMC7082740 DOI: 10.2196/13106] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 06/13/2019] [Accepted: 10/22/2019] [Indexed: 01/09/2023] Open
Abstract
Background Electronic health (eHealth) services may help people obtain information and manage their health, and they are gaining attention as technology improves, and as traditional health services are placed under increasing strain. We present findings from the first representative, large-scale, population-based study of eHealth use in Norway. Objective The objectives of this study were to examine the use of eHealth in a population above 40 years of age, the predictors of eHealth use, and the predictors of taking action following the use of these eHealth services. Methods Data were collected through a questionnaire given to participants in the seventh survey of the Tromsø Study (Tromsø 7). The study involved a representative sample of the Norwegian population aged above 40 years old. A subset of the more extensive questionnaire was explicitly related to eHealth use. Data were analyzed using logistic regression analyses. Results Approximately half (52.7%; 9752/18,497) of the respondents had used some form of eHealth services during the last year. About 58% (5624/9698) of the participants who had responded to a question about taking some type of action based on information gained from using eHealth services had done so. The variables of being a woman (OR 1.58; 95% CI 1.47-1.68), of younger age (40-49 year age group: OR 4.28, 95% CI 3.63-5.04), with a higher education (tertiary/long: OR 3.77, 95% CI 3.40-4.19), and a higher income (>1 million kr [US $100,000]: OR 2.19, 95% CI 1.77-2.70) all positively predicted the use of eHealth services. Not living with a spouse (OR 1.14, 95% CI 1.04-1.25), having seen a general practitioner (GP) in the last year (OR 1.66, 95% CI 1.53-1.80), and having had some disease (such as heart disease, cancer, asthma, etc; OR 1.29, 95% CI 1.18-1.41) also positively predicted eHealth use. Self-rated health status did not significantly influence eHealth use. Taking some action following eHealth use was predicted with the variables of being a woman (OR 1.16, 95% CI 1.07-1.27), being younger (40-49 year age group: OR 1.72, 95% CI 1.34-2.22), having a higher education (tertiary/long: OR 1.65, 95% CI 1.42-1.92), having seen a GP in the last year (OR 1.58, 95% CI 1.41-1.77), and having ever had a disease (such as heart disease, cancer or asthma; OR 1.26, 95% CI 1.14-1.39). Conclusions eHealth appears to be an essential supplement to traditional health services for those aged above 40 years old, and especially so for the more resourceful. Being a woman, being younger, having higher education, having had a disease, and having seen a GP in the last year all positively predicted using the internet to get health information and taking some action based on this information.
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Affiliation(s)
- Rolf Wynn
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Division of Mental Health and Addictions, University Hospital of North Norway, Tromsø, Norway
| | - Sunday Oluwafemi Oyeyemi
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Andrius Budrionis
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Luis Marco-Ruiz
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | | | - Johan Gustav Bellika
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
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6
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Yigzaw KY, Wynn R, Marco-Ruiz L, Budrionis A, Oyeyemi SO, Fagerlund AJ, Bellika JG. The Association Between Health Information Seeking on the Internet and Physician Visits (The Seventh Tromsø Study - Part 4): Population-Based Questionnaire Study. J Med Internet Res 2020; 22:e13120. [PMID: 32134387 PMCID: PMC7082732 DOI: 10.2196/13120] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 09/03/2019] [Accepted: 12/16/2019] [Indexed: 02/06/2023] Open
Abstract
Background The internet is being widely used for seeking health information. However, there is no consensus on the association between health information seeking on the internet and the use of health care services. Objective We examined the association between health information seeking via the internet and physician visits. In addition, we investigated the association between online health information seeking and the decisions to visit and not to visit a physician. Methods We used the cross-sectional electronic health (eHealth) data of 18,197 participants from the seventh survey of the Tromsø Study (Tromsø 7). The participants were aged ≥40 years and living in Tromsø, Norway. We used logistic regression models to examine the association between online health information seeking and physician visits, the decision to visit a physician, and the decision not to visit a physician, with adjustment for the demographic status, socioeconomic status, and health status of the participants. Results The use of Web search engines was associated with a physician visit. However, the association was moderated by age, and the OR decreased as age increased. The ORs for the use of Web search engines were 1.99 (95% CI 1.94-2.02) and 1.07 (95% CI 1.03-1.12) at ages 40 and 80 years, respectively. The decision to visit a physician was associated with the use of Web search engines (OR 2.95, 95% CI 2.03-4.46), video search engines (OR 1.43, 95% CI 1.21-1.70), and health apps (OR 1.26, 95% CI 1.13-1.42). The association between social media use and the decision to visit a physician was moderated by gender. Women who used social media had 1.42 (95% CI 1.31-1.55) times higher odds of deciding to visit a physician, whereas the decision to visit a physician was not different between men who used social media and those who did not use social media. Conversely, the decision not to visit a physician was associated with the use of Web search engines (OR 2.78, 95% CI 1.92-4.18), video search engines (OR 1.27, 95% CI 1.07-1.51), social media (OR 1.28, 95% CI 1.10-1.49), and health apps (OR 1.20, 95% CI 1.07-1.35). Conclusions Health information found on the internet was positively associated with both the decision to visit a physician and the decision not to visit a physician. However, the association of health information seeking with the decision to visit a physician was slightly stronger than the association with the decision not to visit a physician. This could imply that the use of eHealth services is associated with a resultant increase in physician visits. In summary, our findings suggest that the internet serves as a supplement to health care services rather than as a replacement.
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Affiliation(s)
| | - Rolf Wynn
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Division of Mental Health and Addictions, University Hospital of North Norway, Tromsø, Norway
| | - Luis Marco-Ruiz
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Andrius Budrionis
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Sunday Oluwafemi Oyeyemi
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Johan Gustav Bellika
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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7
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Marco-Ruiz L, Wynn R, Oyeyemi SO, Budrionis A, Yigzaw KY, Bellika JG. Impact of Illness on Electronic Health Use (The Seventh Tromsø Study - Part 2): Population-Based Questionnaire Study. J Med Internet Res 2020; 22:e13116. [PMID: 32134390 PMCID: PMC7082738 DOI: 10.2196/13116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 08/09/2019] [Accepted: 09/26/2019] [Indexed: 12/14/2022] Open
Abstract
Background Patients who suffer from different diseases may use different electronic health (eHealth) resources. Thus, those who plan eHealth interventions should take into account which eHealth resources are used most frequently by patients that suffer from different diseases. Objective The aim of this study was to understand the associations between different groups of chronic diseases and the use of different eHealth resources. Methods Data from the seventh survey of the Tromsø Study (Tromsø 7) were analyzed to determine how different diseases influence the use of different eHealth resources. Specifically, the eHealth resources considered were use of apps, search engines, video services, and social media. The analysis contained data from 21,083 participants in the age group older than 40 years. A total of 15,585 (15,585/21,083; 73.92%) participants reported to have suffered some disease, 10,604 (10,604/21,083; 50.29%) participants reported to have used some kind of eHealth resource in the last year, and 7854 (7854/21,083; 37.25%) participants reported to have used some kind of eHealth resource in the last year and suffered (or had suffered) from some kind of specified disease. Logistic regression was used to determine which diseases significantly predicted the use of each eHealth resource. Results The use of apps was increased among those individuals that (had) suffered from psychological problems (odds ratio [OR] 1.39, 95% CI 1.23-1.56) and cardiovascular diseases (OR 1.12, 95% CI 1.01-1.24) and those part-time workers that (had) suffered from any of the diseases classified as others (OR 2.08, 95% CI 1.35-3.32). The use of search engines for accessing health information increased among individuals who suffered from psychological problems (OR 1.39, 95% CI 1.25-1.55), cancer (OR 1.26, 95% CI 1.11-1.44), or any of the diseases classified as other diseases (OR 1.27, 95% CI 1.13-1.42). Regarding video services, their use for accessing health information was more likely when the participant was a man (OR 1.31, 95% CI 1.13-1.53), (had) suffered from psychological problems (OR 1.70, 95% CI 1.43-2.01), or (had) suffered from other diseases (OR 1.43, 95% CI 1.20-1.71). The factors associated with an increase in the use of social media for accessing health information were as follows: (had) suffered from psychological problems (OR 1.65, 95% CI 1.42-1.91), working part time (OR 1.35, 95% CI 0.62-2.63), receiving disability benefits (OR 1.42, 95% CI 1.14-1.76), having received an upper secondary school education (OR 1.20, 95% CI 1.03-1.38), being a man with a high household income (OR 1.67, 95% CI 1.07-2.60), suffering from cardiovascular diseases and having a high household income (OR 3.39, 95% CI 1.62-8.16), and suffering from respiratory diseases while being retired (OR 1.95, 95% CI 1.28-2.97). Conclusions Our findings show that different diseases are currently associated with the use of different eHealth resources. This knowledge is useful for those who plan eHealth interventions as they can take into account which type of eHealth resource may be used for gaining the attention of the different user groups.
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Affiliation(s)
- Luis Marco-Ruiz
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Rolf Wynn
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Division of Mental Health and Addictions, University Hospital of North Norway, Tromsø, Norway
| | - Sunday Oluwafemi Oyeyemi
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Andrius Budrionis
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | | | - Johan Gustav Bellika
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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8
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Budrionis A, Wynn R, Marco-Ruiz L, Yigzaw KY, Bergvik S, Oyeyemi SO, Bellika JG. Impact of the Use of Electronic Health Tools on the Psychological and Emotional Well-Being of Electronic Health Service Users (The Seventh Tromsø Study - Part 3): Population-Based Questionnaire Study. J Med Internet Res 2020; 22:e13118. [PMID: 32134396 PMCID: PMC7082736 DOI: 10.2196/13118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/24/2019] [Accepted: 08/31/2019] [Indexed: 01/18/2023] Open
Abstract
Background Electronic health (eHealth) has been described as a silver bullet for addressing how challenges of the current health care system may be solved by technological solutions in future strategies and visions for modern health care. However, the evidence of its effects on service quality and cost effectiveness remains unclear. In addition, patients’ psychological and emotional reactions to using eHealth tools are rarely addressed by the scientific literature. Objective This study aimed to assess how the psychological and emotional well-being of eHealth service users is affected by the use of eHealth tools. Methods We analyzed data from a population-based survey in Norway, conducted in the years 2015-2016 and representing 10,604 eHealth users aged over 40 years, to identify how the use of eHealth tools was associated with feeling anxious, confused, knowledgeable, or reassured. Associations between these four emotional outcomes and the use of four types of eHealth services (Web search engines, video search engines, health apps, and social media) were analyzed using logistic regression models. Results The use of eHealth tools made 72.41% (6740/9308) of the participants feel more knowledgeable and 47.49% (4421/9308) of the participants feel more reassured about their health status. However, 25.69% (2392/9308) reported feeling more anxious and 27.88% (2595/9308) reported feeling more confused using eHealth tools. A high level of education and not having a full-time job were associated with positive reactions and emotions (feeling more knowledgeable and reassured), whereas low self-reported health status and not having enough friends who could provide help and support predicted negative reactions and emotions (ie, feeling anxious and confused). Overall, the positive emotional effects of eHealth use (feeling knowledgeable and reassured) were relatively more prevalent among users aged over 40 years than the negative emotional effects (ie, feeling anxious and confused). About one-fourth of eHealth users reported being more confused and anxious after using eHealth services. Conclusions The search for health information on the internet can be motivated by a range of factors and needs (not studied in this study), and people may experience a range of reactions and feelings following health information searching on the Web. Drawing on prior studies, we categorized reactions as positive and negative reactions. Some participants had negative reactions, which is challenging to resolve and should be taken into consideration by eHealth service providers when designing services (ie, including concrete information about how users can get more help and support). There is a need for more studies examining a greater range of reactions to online health information and factors that might predict negative reactions to health information on the Web.
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Affiliation(s)
- Andrius Budrionis
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Rolf Wynn
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Division of Mental Health and Addictions, University Hospital of North Norway, Tromsø, Norway
| | - Luis Marco-Ruiz
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | | | - Svein Bergvik
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sunday Oluwafemi Oyeyemi
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Johan Gustav Bellika
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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9
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Yigzaw KY, Michalas A, Bellika JG. Secure and scalable deduplication of horizontally partitioned health data for privacy-preserving distributed statistical computation. BMC Med Inform Decis Mak 2017; 17:1. [PMID: 28049465 PMCID: PMC5209873 DOI: 10.1186/s12911-016-0389-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 11/10/2016] [Indexed: 11/17/2022] Open
Abstract
Background Techniques have been developed to compute statistics on distributed datasets without revealing private information except the statistical results. However, duplicate records in a distributed dataset may lead to incorrect statistical results. Therefore, to increase the accuracy of the statistical analysis of a distributed dataset, secure deduplication is an important preprocessing step. Methods We designed a secure protocol for the deduplication of horizontally partitioned datasets with deterministic record linkage algorithms. We provided a formal security analysis of the protocol in the presence of semi-honest adversaries. The protocol was implemented and deployed across three microbiology laboratories located in Norway, and we ran experiments on the datasets in which the number of records for each laboratory varied. Experiments were also performed on simulated microbiology datasets and data custodians connected through a local area network. Results The security analysis demonstrated that the protocol protects the privacy of individuals and data custodians under a semi-honest adversarial model. More precisely, the protocol remains secure with the collusion of up to N − 2 corrupt data custodians. The total runtime for the protocol scales linearly with the addition of data custodians and records. One million simulated records distributed across 20 data custodians were deduplicated within 45 s. The experimental results showed that the protocol is more efficient and scalable than previous protocols for the same problem. Conclusions The proposed deduplication protocol is efficient and scalable for practical uses while protecting the privacy of patients and data custodians. Electronic supplementary material The online version of this article (doi:10.1186/s12911-016-0389-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kassaye Yitbarek Yigzaw
- Department of Computer Science, UiT The Arctic University of Norway, 9037, Tromsø, Norway. .,Norwegian Centre for E-health Research, University Hospital of North Norway, 9019, Tromsø, Norway.
| | - Antonis Michalas
- Department of Computer Science, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
| | - Johan Gustav Bellika
- Norwegian Centre for E-health Research, University Hospital of North Norway, 9019, Tromsø, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
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10
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Bellika JG, Hartvigsen G, Sletteng Ø. The patient diary as a tool for patient empowerment. J Telemed Telecare 2016. [DOI: 10.1258/1357633042614456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- J G Bellika
- Norwegian Centre for Telemedicine, University Hospital of North Norway
| | - G Hartvigsen
- Norwegian Centre for Telemedicine, University Hospital of North Norway
- Department of Computer Science, Faculty of Science, University of Tromsø, Norway
| | - Ø Sletteng
- Norwegian Centre for Telemedicine, University Hospital of North Norway
- Department of Computer Science, Faculty of Science, University of Tromsø, Norway
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Budrionis A, Bellika JG. The Learning Healthcare System: Where are we now? A systematic review. J Biomed Inform 2016; 64:87-92. [PMID: 27693565 DOI: 10.1016/j.jbi.2016.09.018] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 09/14/2016] [Accepted: 09/27/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE The Learning Healthcare System paradigm has attracted the attention of researchers worldwide. The great potential originating from high-scale health data reuse and the inclusion of patient perspectives into care models promises personalized care, lower costs of health services and minimized consumption of resources. The aim of this review is to summarize the attempts to adopt the novel paradigm, putting emphasis on implementations and evaluating the impact on current medical practices. METHOD PRISMA methodology was followed for structuring the review process. Three major research databases (PubMed, IEEE Xplore and ACM DL) were queried with the predefined search terms "learning healthcare" and "learning health". Publications containing specific theoretical or empirical results were considered. RESULTS Three hundred and fifty-eight publications were identified; however, only 32 met the inclusion criteria. Nineteen papers were characterized as theoretical contributions, while the rest presented empirical achievements. Only one paper described the initial estimates of impact and economy. DISCUSSION Individualistic communication of studies ignoring popular frameworks for assessing and reporting research achievements prevents the systematic generation of knowledge. Evaluating the impact of the Learning Healthcare System instances where it is implemented could work as a catalyst in reaching higher acceptance and adoption of the proposed ideas by healthcare worldwide; however, it mostly remains described in theory. CONCLUSIONS The review demonstrated the interest of researchers in exploring the Learning Healthcare System ideas. However, it also revealed minimal focus on evaluating the impact of the novel paradigm on both healthcare service delivery and patient outcome.
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Affiliation(s)
- Andrius Budrionis
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.
| | - Johan Gustav Bellika
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
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12
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Abstract
Systems for large-scale reuse of electronic health record data is claimed to have the potential to transform the current health care delivery system. In principle three alternative solutions for reuse exist: centralized, data warehouse, and decentralized solutions. This chapter focuses on the decentralized system alternative. Decentralized systems may be categorized into approaches that move data to enable computations or move computations to the where data is located to enable computations. We describe a system that moves computations to where the data is located. Only this kind of decentralized solution has the capabilities to become ideal systems for reuse as the decentralized alternative enables computation and reuse of electronic health record data without moving or exposing the information to outsiders. This chapter describes the Snow system, which is a decentralized medical data processing system, its components and how it has been used. It also describes the requirements this kind of systems need to support to become sustainable and successful in recruiting voluntary participation from health institutions.
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Affiliation(s)
- Johan Gustav Bellika
- Norwegian Centre for Integrated Care and Telemedicine (NST), 35, 9038, Tromso, Norway,
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Budrionis A, Hasvold P, Hartvigsen G, Bellika JG. Assessing the impact of telestration on surgical telementoring: A randomized controlled trial. J Telemed Telecare 2015; 22:12-7. [PMID: 26026177 DOI: 10.1177/1357633x15585071] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/10/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Using graphical annotations in surgical telementoring promises vast improvements in both clinical and educational outcomes. However, these assumptions do not consider the potential patient safety risks resulting from this feature. Major differences in regulations regarding the implementation of telestration encourage an assessment of the utility of this feature on the outcomes of telementoring sessions. METHODS Eight students participated in a randomized controlled trial, comparing verbal with annotation-supplemented telementoring via video conferencing. A remote mentor guided the participants through four localization exercises, identifying the features in a still laparoscopic surgery scene using a laparoscopic simulator. Clinical and educational outcomes were assessed; the time consumption and quality of mentoring were determined. RESULTS The study revealed no significant difference in localizing the intervention between the studied methods, while educational outcomes favoured verbal mentoring. Telestration-supplemented guidance was considerably faster and resulted in fewer miscommunications between the mentor and mentee. DISCUSSION The initial hypothesis of the major clinical and education benefits of telestration in telementoring was not supported. A potential 33% decrease in the duration of the mentored episodes is expected due to the ability to annotate live video content. However, the impact of time saving on the outcome of the procedure remains unclear. Regardless of the quantitative measures, most of the participants and the mentor agreed that graphical annotations provide advantages over verbal guidance.
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Affiliation(s)
- Andrius Budrionis
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway
| | - Per Hasvold
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway
| | - Gunnar Hartvigsen
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway
| | - Johan Gustav Bellika
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway
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Budrionis A, Hartvigsen G, Lindsetmo RO, Bellika JG. What device should be used for telementoring? Randomized controlled trial. Int J Med Inform 2015; 84:715-23. [PMID: 26048739 DOI: 10.1016/j.ijmedinf.2015.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 05/13/2015] [Accepted: 05/15/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVE The paper analyzes behavioral patterns of mentors while using different mentoring devices to demonstrate the feasibility of multi-platform mentoring. The fundamental differences of devices supporting telementoring create threats for the perception and interpretation of the transmitted video, highlighting the necessity of exploring hardware usability aspects in a safety critical surgical mentoring scenario. MATERIALS AND METHODS Three types of devices, based on the screen size, formed the arms for the randomized controlled trial. Streaming video recordings of a laparoscopic procedure to the mentors imitated the mentoring scenario. User preferences and response times were recorded while participating in a session performed on all devices. RESULTS Median response to a mentoring request times were similar for mobile platforms; expected durations were considerably longer for stationary computer. Ability to perceive and identify anatomical structures was insignificantly lower on small sized devices. Stationary and tablet platforms were nearly equally preferred by the most of participants as default telementoring hardware. DISCUSSION As a side effect, incompatibility of daily duties of the surgeons in the hospital and telementoring responsibilities while implementing systems locally was identified. Scaling up the use of the service in combination with the organizational changes of clinical staff looks like a promising solution. CONCLUSION The trial demonstrated the feasibility of using all three types of devices for the purpose of mentoring, allowing users to choose the preferred platform. The paper provided initial results on the quality assurance of telementoring systems imposed by the regulatory documents.
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Affiliation(s)
- Andrius Budrionis
- Norwegian Centre for Integrated Care and Telemedicine University Hospital of North Norway, Tromsø, Norway.
| | - Gunnar Hartvigsen
- Norwegian Centre for Integrated Care and Telemedicine University Hospital of North Norway, Tromsø, Norway
| | - Rolv-Ole Lindsetmo
- Department of Gastroenterological Surgery University Hospital of North Norway, Tromsø, Norway
| | - Johan Gustav Bellika
- Norwegian Centre for Integrated Care and Telemedicine University Hospital of North Norway, Tromsø, Norway
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Kampik T, Larsen F, Bellika JG. Internet-based remote consultations - general practitioner experience and attitudes in Norway and Germany. Stud Health Technol Inform 2015; 210:452-454. [PMID: 25991185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
UNLABELLED The objective of the study was to identify experiences and attitudes of German and Norwegian general practitioners (GPs) towards Internet-based remote consultation solutions supporting communication between GPs and patients in the context of the German and Norwegian healthcare systems. METHODS Interviews with four German and five Norwegian GPs were conducted. The results were qualitatively analyzed. RESULTS All interviewed GPs stated they would like to make use of Internet-based remote consultations in the future. Current experiences with remote consultations are existent to a limited degree. No GP reported to use a comprehensive remote consultation solution. The main features GPs would like to see in a remote consultation solution include asynchronous exchange of text messages, video conferencing with text chat, scheduling of remote consultation appointments, secure login and data transfer and the integration of the remote consultation solution into the GP's EHR system.
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Affiliation(s)
- Timotheus Kampik
- Department of Computer Science, Faculty of Science and Technology, UiT The Artic University of Norway
| | - Frank Larsen
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway
| | - Johan Gustav Bellika
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway
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Marco-Ruiz L, Bellika JG. Semantic Interoperability in Clinical Decision Support Systems: A Systematic Review. Stud Health Technol Inform 2015; 216:958. [PMID: 26262260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The interoperability of Clinical Decision Support (CDS) systems with other health information systems has become one of the main limitations to their broad adoption. Semantic interoperability must be granted in order to share CDS modules across different health information systems. Currently, numerous standards for different purposes are available to enable the interoperability of CDS systems. We performed a literature review to identify and provide an overview of the available standards that enable CDS interoperability in the areas of clinical information, decision logic, terminology, and web service interfaces.
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Affiliation(s)
- Luis Marco-Ruiz
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway
| | - Johan Gustav Bellika
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway
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17
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Hailemichael MA, Marco-Ruiz L, Bellika JG. Privacy-preserving Statistical Query and Processing on Distributed OpenEHR Data. Stud Health Technol Inform 2015; 210:766-770. [PMID: 25991257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
UNLABELLED Reuse of data from EHRs is essential for many purposes. The objective of the study was to explore how distributed electronic health record (EHR) data can be reused for privacy-preserving statistical query and processing. METHOD We have designed and created a proof of concept prototype solution based on the OpenEHR specification to ensure interoperability and to query the EHRs. XMPP was used for communication between the distributed processing components. RESULTS We have created a two-phased process where a distributed virtual dataset is first created and thereafter processed using distributed privacy-preserving statistical queries. CONCLUSION Health authorities in Norway are currently defining the set of archetypes for the national interoperability program. This will create a common information schema enabling reuse of EHR data for statistical query and processing in a privacy-preserving manner. One benefit of the approach is that information transformation between information models for clinical use and statistical processing can be avoided.
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Affiliation(s)
| | - Luis Marco-Ruiz
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway
| | - Johan Gustav Bellika
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway
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18
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Budrionis A, Hasvold P, Hartvigsen G, Bellika JG. Video Conferencing Services in Healthcare: One Communication Platform to Support All. Stud Health Technol Inform 2015; 216:887. [PMID: 26262189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We present a novel approach to the design of video conferencing (VC) systems, taking advantage of recent technological achievements in web-based implementation. Delivering VC functionality as a service over the Internet opens new grounds for easier integration, support, and application in many scenarios, since hardware-agnostic ad-hoc VC connections are a feature of the proposed architecture. Validity is demonstrated through latency measures in surgical telementoring service and comparing them to reported thresholds.
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Affiliation(s)
- Andrius Budrionis
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromoso, Norway
| | - Per Hasvold
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromoso, Norway
| | - Gunnar Hartvigsen
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromoso, Norway
| | - Johan Gustav Bellika
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromoso, Norway
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Budrionis A, Augestad KM, Patel HR, Bellika JG. An evaluation framework for defining the contributions of telestration in surgical telementoring. Interact J Med Res 2013; 2:e14. [PMID: 23887078 PMCID: PMC3742399 DOI: 10.2196/ijmr.2611] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 06/26/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND An increasing quantity of research in the domain of telemedicine show a growing popularity and acceptance of care over distance systems among both clinicians and patients. We focus on telementoring solutions, developed for providing remote guidance to less experienced surgeons. Telestration is often regarded as an extra functionality of some telementoring systems. However, we advocate that telestration must be viewed as a core feature of telementoring due to its advantages. OBJECTIVE To analyze and define concepts, parameters, and measurement procedures to evaluate the impact of using telestration while telementoring. METHODS A systematic review of research dealing with telestration during remote guidance sessions was performed by querying three major online research databases (MEDLINE, Association of Computing Machinery, and Institute of Electrical and Electronics Engineers) using a predefined set of keywords ("laparoscopy", "annotate", "telestrate", "telestration", "annotation", "minimally invasive", and "MIS"). RESULTS The keyword-based search identified 117 papers. Following the guidelines for performing a systematic review, only 8 publications were considered relevant for the final study. Moreover, a gap in research defining the impacts of telestration during telementoring was identified. To fill this niche, a framework for analyzing, reporting, and measuring the impacts of telestration was proposed. CONCLUSIONS The presented framework lays the basics for the structured analysis and reporting of telestration applied to telementoring systems. It is the first step toward building an evidence knowledge base documenting the advantages of live video content annotation and supporting the presented connections between the concepts.
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Affiliation(s)
- Andrius Budrionis
- Faculty of Science and Technology, Department of Computer Science, University of Tromsø, Tromsø, Norway.
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20
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Abstract
Kernel density estimation and kernel regression are useful ways to visualize and assess the structure of data. Using these techniques we define a temporal scale space as the vector space spanned by bandwidth and a temporal variable. In this space significance regions that reflect a significant derivative in the kernel smooth similar to those of SiZer (Significant Zero-crossings of derivatives) are indicated. Significance regions are established by hypothesis tests for significant gradient at every point in scale space. Causality is imposed onto the space by restricting to kernels with left-bounded or finite support and shifting kernels forward. We show that these adjustments to the methodology enable early detection of changes in time series constituting live surveillance systems of either count data or unevenly sampled measurements. Warning delays are comparable to standard techniques though comparison shows that other techniques may be better suited for single-scale problems. Our method reliably detects change points even with little to no knowledge about the relevant scale of the problem. Hence the technique will be applicable for a large variety of sources without tailoring. Furthermore this technique enables us to obtain a retrospective reliable interval estimate of the time of a change point rather than a point estimate. We apply the technique to disease outbreak detection based on laboratory confirmed cases for pertussis and influenza as well as blood glucose concentration obtained from patients with diabetes type 1.
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Affiliation(s)
- Stein Olav Skrøvseth
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway.
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Augestad KM, Bellika JG, Budrionis A, Chomutare T, Lindsetmo RO, Patel H, Delaney C. Surgical telementoring in knowledge translation--clinical outcomes and educational benefits: a comprehensive review. Surg Innov 2012; 20:273-81. [PMID: 23117447 DOI: 10.1177/1553350612465793] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Surgical telementoring has been reported for decades. However, there exists limited evidence of clinical outcome and educational benefits. OBJECTIVE To perform a comprehensive review of surgical telementoring surveys published in the past 2 decades. RESULTS Of 624 primary identified articles, 34 articles were reviewed. A total of 433 surgical procedures were performed by 180 surgeons. Most common telementored procedures were laparoscopic cholecystectomy (57 cases, 13%), endovascular treatment of aortic aneurysm (48 cases, 11%), laparoscopic colectomy (32 cases, 7%), and nefrectomies (41 cases, 9%). In all, 167 (38%) cases had a laparoscopic approach, and 8 cases (5%) were converted to open surgery. Overall, 20 complications (5%) were reported (liver bleeding, trocar port bleeding, bile collection, postoperative ileus, wound infection, serosa tears, iliac artery rupture, conversion open surgery). Eight surveys (23%) have structured assessment of educational outcomes. Telementoring was combined with simulators (n = 2) and robotics (n = 3). Twelve surveys (35%) were intercontinental. Technology satisfaction was high among 83% of surgeons. CONCLUSION Few surveys have a structured assessment of educational outcome. Telementoring has improved impact on surgical education. Reported complication rate was 5%.
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Augestad KM, Berntsen G, Lassen K, Bellika JG, Wootton R, Lindsetmo RO. Standards for reporting randomized controlled trials in medical informatics: a systematic review of CONSORT adherence in RCTs on clinical decision support. J Am Med Inform Assoc 2012; 19:13-21. [PMID: 21803926 PMCID: PMC3240766 DOI: 10.1136/amiajnl-2011-000411] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 06/29/2011] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The Consolidated Standards for Reporting Trials (CONSORT) were published to standardize reporting and improve the quality of clinical trials. The objective of this study is to assess CONSORT adherence in randomized clinical trials (RCT) of disease specific clinical decision support (CDS). METHODS A systematic search was conducted of the Medline, EMBASE, and Cochrane databases. RCTs on CDS were assessed against CONSORT guidelines and the Jadad score. RESULT 32 of 3784 papers identified in the primary search were included in the final review. 181 702 patients and 7315 physicians participated in the selected trials. Most trials were performed in primary care (22), including 897 general practitioner offices. RCTs assessing CDS for asthma (4), diabetes (4), and hyperlipidemia (3) were the most common. Thirteen CDS systems (40%) were implemented in electronic medical records, and 14 (43%) provided automatic alerts. CONSORT and Jadad scores were generally low; the mean CONSORT score was 30.75 (95% CI 27.0 to 34.5), median score 32, range 21-38. Fourteen trials (43%) did not clearly define the study objective, and 11 studies (34%) did not include a sample size calculation. Outcome measures were adequately identified and defined in 23 (71%) trials; adverse events or side effects were not reported in 20 trials (62%). Thirteen trials (40%) were of superior quality according to the Jadad score (≥3 points). Six trials (18%) reported on long-term implementation of CDS. CONCLUSION The overall quality of reporting RCTs was low. There is a need to develop standards for reporting RCTs in medical informatics.
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Affiliation(s)
- K M Augestad
- Department of Telemedicine and Integrated Care, University Hospital North Norway, Tromsø, Norway
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Guirao Aguilar J, Bellika JG, Fernandez Luque L, Traver Salcedo V. Respiration tracking using the Wii remote game controller. Stud Health Technol Inform 2011; 169:455-459. [PMID: 21893791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Respiration exercises are an important part in the pulmonary rehabilitation of COPD (chronic obstructive pulmonary disease) patients. Furthermore, previous research has demonstrated that showing respiration pattern helps the patients to improve their breathing skills. We have developed a low cost and non-invasive prototype based on the Wii remote game controller infrared camera to provide BPM (breaths per minute) measurement as feedback. It can also be a comfortable solution without wires, batteries or any kind of electronics but just wearing passive markers. The lab evaluation with 7 healthy individuals showed that this approach is feasible when users are resting of their exercise. The BPM monitored during the tests presented less than 15% of maximum error and the RMSE (root mean square error) was lower than 6% in all the tests. Further research is needed to evaluate and adapt the system for COPD patients. In addition, more work is needed to develop applications that can be built to motivate and guide the users.
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Affiliation(s)
- J Guirao Aguilar
- Department of Computer Science, Faculty of Science and Technology, University of Tromsø, Norway.
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Johansen MA, Berntsen G, Shrestha N, Bellika JG, Johnsen JAK. An exploratory study of patient attitudes towards symptom reporting in a primary care setting. Benefits for medical consultation and syndromic surveillance? Methods Inf Med 2010; 50:479-86. [PMID: 21897995 DOI: 10.3414/me11-02-0005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Accepted: 07/05/2011] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The aim of this study was to investigate people's attitude towards providing symptom information electronically before a consultation. Specific areas investigated include a) attitudes and experiences with regards to acquisition of information related to symptoms, b) attitudes towards computer based communication of symptoms to the general practitioner and how they preferred to carry out such reporting, and c) attitudes towards storage, use and presentation of symptom-data in general, and particularly in a symptom based surveillance setting. METHODS Data was collected from 83 respondents by use of convenience sampling. RESULTS The respondents were familiar with using the Internet for health purposes, such as acquisition of information related to their symptoms prior to a consultation. The majority of respondents had a positive attitude towards providing information about their symptoms to the general practitioner's office as soon as possible after falling ill. Over half of the respondents preferred to use e-mail or a web-interface to perform this task. Eighty four percent were willing to have their symptom data stored in their EPR and 76 percent agreed that the general practitioner might access the symptoms together with the prevalence of matching diseases in order to assist the diagnostic process during the next consultation. CONCLUSIONS The results of this study support the applicability of electronically mediated pre-consultation systems both for improving primary care consultation and for use in symptom based surveillance, including real-time surveillance.
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Affiliation(s)
- M A Johansen
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, 9038 Tromsø, Norway.
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Johansen MA, Johnsen JAK, Shrestha N, Bellika JG. Symptoms from patients as the primary information source for real-time surveillance. Stud Health Technol Inform 2010; 160:427-431. [PMID: 20841722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The aim of this study was to identify whether patients could become the primary data source for symptom based real-time surveillance. The study investigated people's attitude towards providing symptom information electronically before a consultation, and how they preferred to carry out the reporting. Data was collected by distributing questionnaires to 83 respondents. The results show that 96 percent of the respondents had a positive attitude towards providing information about their symptoms to the GP's office as soon as possible after falling ill. Over half of the respondents preferred to use e-mail or a web-interface to perform this task. Eighty four percent were willing to have their symptom data stored in their EPR and 76 percent agreed that the GP might access and present the symptoms together with the prevalence of matching diseases in order to assist the diagnostic process during the next consultation. This study indicates that patients could become the primary data source for symptom based surveillance in countries with high e-readiness.
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Affiliation(s)
- Monika Alise Johansen
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Department of Telemedicine and e-Health, University of Tromsø, Tromsø, Norway.
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Botsis T, Walderhaug S, Dias A, van Vuurden K, Bellika JG, Hartvigsen G. Point-of-care devices for healthy consumers - a feasibility study. J Telemed Telecare 2009; 15:419-20. [PMID: 19948710 DOI: 10.1258/jtt.2009.090510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Taxiarchis Botsis
- Department of Computer Science, University of Tromsø, 9037 Tromsø, Norway.
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Bellika JG, Ilebrekke L, Bakkevoll PA, Johansen H, Scholl J, Johansen MA. Authentication and encryption in the Snow disease surveillance network. Stud Health Technol Inform 2009; 150:725-729. [PMID: 19745406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The paper presents how authentication and encryption is implemented in the Snow disease surveillance network. Requirements for the authentication mechanism were collected from General Practitioners (GPs). The identity of each Snow user is preserved across health institutions allowing GPs to move freely between health institutions and use the system independent of location. This ability is combined with close to zero user account administration within the participating institutions. The system provides global user certificate revocation and end-to-end encryption.
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Johansen MA, Fossen K, Norum J, Christoffersen T, Oritsland H, Haga D, Hasvold P, Bellika JG, Knarvik U, Pedersen S. The potential of digital monochrome images versus colour slides in telescreening for diabetic retinopathy. J Telemed Telecare 2008; 14:27-31. [PMID: 18318926 DOI: 10.1258/jtt.2007.060401] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We explored the potential of digital monochrome images as an alternative to colour slides in screening for diabetic retinopathy. Twenty-eight patients with diabetes were recruited for the study and 20 actually participated. Using a fundus camera (Nikon 505AF) one set of three digital images and one set of three colour slides were taken per eye. Two independent ophthalmologists graded the colour slides and the digital images for diabetic retinopathy. The ophthalmologists spent about two minutes grading each set of images, suggesting that specialists could potentially screen a large number of patients. The agreement between the two screening methods was 0.95 and 0.89, with respect to disease or no disease. The agreement (kappa) between the two ophthalmologists for grade of retinopathy was 0.47 when colour slides were employed and 0.61 when digital monochrome images were employed. The results indicate that digital red-free monochrome images represent a superior screening tool for diabetic retinopathy. Tele-screening may be beneficial when patients have to travel substantial distances to visit an ophthalmologist.
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Affiliation(s)
- Monika Alise Johansen
- Norwegian Centre for Telemedicine, University Hospital of North Norway, Tromsø, Norway.
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van Vuurden K, Hartvigsen G, Bellika JG. Disease outbreak detection through clique covering on a weighted ICPC-coded graph. Stud Health Technol Inform 2008; 136:271-276. [PMID: 18487743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Even after a decade of increased research into the problem of detecting disease outbreaks, we lack a system that can limit the number of patients affected by a potential epidemic by recognising its existence at an early stage. In this paper we suggest the use of a weighted graph representing symptoms with an exceptionally high prevalence. Cliques with high weighted edges in such a graph will represent groups of symptoms that occur together more often than usual. As a result each clique will represent the main symptoms of a disease with a high incidence rate. This will make it easier to diagnose the nature of an outbreak, to reach the affected patients at an early stage and to distinguish between outbreaks occurring simultaneously.
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Botsis T, Hejlesen O, Bellika JG, Hartvigsen G. Electronic disease surveillance for sensitive population groups - the diabetics case study. Stud Health Technol Inform 2008; 136:365-370. [PMID: 18487758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Diabetics are quite susceptible to infectious diseases and can easily spread them under certain circumstances. Their blood glucose levels are increased after infection and this can cause a hyperglycemic crisis. Our study indicates that this increase results in glucosylated hemoglobin elevation, even when a diabetic is monitored closely and his/her blood glucose is under tight control. Thus, it is important to detect infections at the very early stages of disease progression in order to aid the patient. For this purpose, an electronic Disease Surveillance System could be developed to collect and analyze blood glucose data. Generally, we could extend the use of blood glucose data to the implementation of disease surveillance systems for the general population.
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Hartvigsen G, Johansen MA, Hasvold P, Bellika JG, Arsand E, Arild E, Gammon D, Pettersen S, Pedersen S. Challenges in telemedicine and eHealth: lessons learned from 20 years with telemedicine in Tromsø. Stud Health Technol Inform 2007; 129:82-6. [PMID: 17911683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The Norwegian Centre for Telemedicine (NST) has, over the past two decades, contributed to the development and implementation of telemedicine and ehealth services in Norway. From 2002, NST has been a WHO Collaboration Center for telemedicine. In August 1996, Norway became the first country to implement an official telemedicine fee schedule making telemedicine services reimbursable by the national health insurer. Telemedicine is widely used in Northern Norway. Since the late 1980's, the University Hospital of North-Norway has experience in the following areas: teleradiology, telepathology, teledermatology, teleotorhinolaryngology (remote endoscopy), remote gastroscopy, tele-echocardiography, remote transmission of ECGs, telepsychiatry, teleophthalmology, teledialysis, teleemergency medicine, teleoncology, telecare, telegeriatric, teledentistry, maritime telemedicine, referrals and discharge letters, electronic delivery of laboratory results and distant teaching for healthcare personnel and patients. Based on the result achieved, the health authority in North-Norway plans to implement several large-scale telemedicine services: Teleradiology (incl. solutions for neurosurgery, orthopedic, different kinds of surgery, nuclear medicine, acute traumatic and oncology), digital communication and integration of patient data, and distant education. In addition, the following services will also be considered for large-scale implementation: teledialysis, prehospital thrombolysis, telepsychiatry, teledermatology. Last in line for implementation are: pediatric, district medical center (DMS), teleophthalmology and ear-nose-throat (ENT).
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Affiliation(s)
- Gunnar Hartvigsen
- Norwegian Centre for Telemedicine, University Hospital of North Norway, Tromsø, Norway.
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Granberg O, Bellika JG, Arsand E, Hartvigsen G. Automatic infection detection system. Stud Health Technol Inform 2007; 129:566-70. [PMID: 17911780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
An infected person may be contagious already before the first symptoms appear. This person can, in the period of disease evolution, infect several associated citizens before consulting a general practitioner (GP). Early detection of contagion is therefore important to prevent spreading of diseases. The Automatic Infection Detection (AID) System faces this problem through investigating the hypothesis that the blood glucose (BG) level increases when a person is infected. The first objective of the prototyped version of the AID system was to identify possible BG elevations in the incubation time that could be related to the spread of infectious diseases. To do this, we monitored two groups of people, with and without diabetes mellitus. The AID system analyzed the results and we were able to detect two cases of infection during the study period. The time of detection occurred simultaneous or near the time of onset of symptoms. The detection did not occur earlier for a number of reasons. The most likely one is that the evolution process of an infectious disease is both complicated and involves the immune system and several organs in the body. The investigation with regard to isolating the key relations is therefore considered as a very complex study. Nevertheless, the AID system managed to detect the infection much earlier than what is possible with today's early warning systems for infectious diseases.
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Affiliation(s)
- Ove Granberg
- Department of Computer Science, Faculty of Science, University of Tromsø, Norway
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Bellika JG, Sue H, Bird L, Goodchild A, Hasvold T, Hartvigsen G. Properties of a federated epidemiology query system. Int J Med Inform 2006; 76:664-76. [PMID: 16949338 DOI: 10.1016/j.ijmedinf.2006.05.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2006] [Revised: 05/10/2006] [Accepted: 05/31/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of the study was to establish knowledge about how online access to epidemiological data from general practitioners (GPs) electronic health record (EHR) system should be provided. Before such systems are developed and deployed a decision about the appropriate system architecture must be made. Such a decision should ideally be based on knowledge about the properties of different system architectures. This choice is important because the system architecture may affect the willingness of GPs to participate in providing epidemiological data from their EHR system. METHOD Verifying the performance and properties of an architectural approach by implementing and deploying a system on a trans-institutional level and performing evaluations studies is a very resource demanding method to establish a foundation for the decision of appropriate system architecture. Instead, we have tried to create this foundation by constructing a prototype system, establish knowledge about the properties of the system using experiments, and finally compare the properties of the federated approach to the properties of the centralised approach. By using this methodological approach we provide the best available knowledge, on this stage, for the appropriate system architecture to use for providing access to epidemiological data from the local population. RESULTS Our experimental results show that it is possible to improve the timeliness and the temporal and spatial resolution of epidemiological data, compared to traditional centralised disease surveillance systems. Up-to-date epidemiological data from the local population may be provided directly from the source EHR system within 4s. The responsiveness of the system is minimally affected (0.1s) as the number of participating data providers grows from 1 to 49 data providers. The comparison of the federated approach to the centralised approach indicates that federated approaches avoid the privacy issues involved, as intended; it offers better scalability when computing speed is compared, and it provides better specificity because more data about the patient may be used. CONCLUSION The conclusion from our study is that the federated approach to providing epidemiological data about the local population has many benefits over the traditional centralised approach. A federated approach to an epidemiology system may raise the GPs awareness of local disease outbreak because it is possible to share information about incidence rates of communicable diseases and use of laboratory requests in a geographical area that predates laboratory-based disease surveillance. The effects of the federated approach could be improved data quality in the EHR systems and improved representativeness of the epidemiological data for the areas covered by such systems.
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Affiliation(s)
- Johan Gustav Bellika
- Norwegian Centre for Telemedicine, University Hospital of North Norway, Postbox 35, 9038 Tromsø, Norway.
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Bellika JG, Hasvold T, Hartvigsen G. Propagation of program control: a tool for distributed disease surveillance. Int J Med Inform 2006; 76:313-29. [PMID: 16621681 PMCID: PMC7108256 DOI: 10.1016/j.ijmedinf.2006.02.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2004] [Revised: 11/08/2005] [Accepted: 02/16/2006] [Indexed: 11/30/2022]
Abstract
Purpose The purpose of the study was (1) to identify the requirements for syndromic, disease surveillance and epidemiology systems arising from events such as the SARS outbreak in March 2003, and the deliberate spread of Bacillus anthracis, or anthrax, in the US in 2001; and (2) to use these specifications as input to the construction of a system intended to meet these requirements. An important goal was to provide information about the diffusion of a communicable disease without being dependent on centralised storage of information about individual patients or revealing patient-identifiable information. Methods The method applied is rooted in the engineering paradigm involving phases of analysis, system specification, design, implementation, and testing. The requirements were established from earlier projects’ conclusions and analysis of disease outbreaks. The requirements were validated by a literature study of syndromic and disease surveillance systems. The system was tested on simulated EHR databases generated from microbiology laboratory data. Results A requirements list that a syndromic and disease surveillance system should meet, and an open source system, “The Snow Agent system”, has been developed. The Snow Agent system is a distributed system for monitoring the status of a population's health by distributing processes to, and extracting epidemiological data directly from, the electronic health records (EHR) system in a geographic area. Conclusions Syndromic and disease surveillance tools should be able to operate at all levels in the health systems and across national borders. Such systems should avoid transferring patient identifiable data, support two-way communications and be able to define and incorporate new and unknown diseases and syndrome definitions that should be reported by the system. The initial tests of the Snow Agent system shows that it will easily scale to national level in Norway.
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Affiliation(s)
- Johan Gustav Bellika
- Norwegian Centre for Telemedicine, University Hospital of North-Norway, P.O. Box 35, NO-9038 Tromsø, Norway.
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Bellika JG, Hartvigsen G. The oncological nurse assistant: a web-based intelligent oncological nurse advisor. Int J Med Inform 2005; 74:587-95. [PMID: 16005257 DOI: 10.1016/j.ijmedinf.2005.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2004] [Revised: 05/27/2005] [Accepted: 06/08/2005] [Indexed: 11/22/2022]
Abstract
When a person gets a cancer diagnosis the need for medical guidance often appears. In Norway, one of the providers of medical guidelines is the Norwegian Cancer Association where oncological nurses assist people with a cancer diagnosis or their relatives. The nurses search through both national and internal guidebooks and web pages. The input to this process is mostly discharge letters. The whole process is time consuming. To serve more patients, PaSent, a web-based intelligent oncological nurse advisor, has been developed. Through using discharge letters as input to our neural network-based information retrieval system PaSent, we have been able to provide relevant medical information to the patient as well as to the health personnel themselves. The PaSent search method uses predefined knowledge about the context, paired with the vocabulary of the input document, to compute a relevance measure for a potential result document. The system has been validated by oncological nurses and medical doctors. In the reported experiments, the PaSent system is able to recommend literature, in the top section of the search result list, that our judges also found highly relevant.
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Affiliation(s)
- Johan Gustav Bellika
- Norwegian Centre for Telemedicine, University Hospital of North Norway, N-9038 Tromsø, Norway.
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Bellika JG, Hartvigsen G. The oncological nurse assistant: a web-based intelligent oncological nurse advisor. Stud Health Technol Inform 2004; 107:573-7. [PMID: 15360877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
As more people get cancer the need for medical guidance increases. In Norway, one of the providers of medical guidelines is the Norwegian Cancer Association where oncological nurses assist people with a cancer diagnosis or their relatives. The nurses search through both national and internal guide-books and web pages. The input to this process is mostly dis-charge letters. The whole process is time consuming. To serve more patients, PaSent, a web-based intelligent oncological nurse advisor, has been developed. Through using discharge letters as input to our neural network based information retrieval system PaSent, we have been able to provide relevant medical information to the patient as well as to the health personnel themselves. The PaSent search method uses predefined knowledge about the context, paired with the vocabulary of the input document, to compute a relevance measure for a potential result document. The system has been validated by oncological nurses and medical doctors. In the reported experiments, the achieved search results from PaSent have been comparable to the results achieved by the health personnel.
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Affiliation(s)
- Johan Gustav Bellika
- Norwegian Centre for Telemedicine, University Hospital of North Norway, N-9038 Tromsø, Norway.
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Bellika JG, Hartvigsen G, Norum J. Using discharge letters and context representation in information retrieval of medical literature. Stud Health Technol Inform 2003; 95:373-8. [PMID: 14664015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Electronic discharge letters are in many cases insufficient as a recipe for further treatment and recovery. Through using discharge letters as input to our neural network based information retrieval system Pasent, we have been able to provide relevant medical information. The Pasent search method uses predefined knowledge about the context, paired with the vocabulary of the input document, to compute a relevance measure for a potential result document. In the reported experiments, we achieved search results comparable to the tftdf method without building specialised context models for the experiment.
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Bellika JG, Bønes E, Hartvigsen G. PaSent--the patient's personal health adviser. J Telemed Telecare 2002; 8 Suppl 2:41-3. [PMID: 12217129 DOI: 10.1177/1357633x020080s218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We have attempted to automate the search for medical information that is relevant to a patient s electronic record. We used anonymous medical reports sent from the University Hospital of Tromsø to general practitioners as input data. The medical reports were matched against the NEL, a Web-based medical dictionary and document collection service for general practitioners. We evaluated only the three top-scoring documents automatically selected by the system. A medical professional evaluated whether a selected document from the NEL was very relevant to the contents of the input report, relevant or irrelevant. Initial tests showed that 60% of the top three selected documents found by the PaSent system were very relevant or relevant to the contents of the medical report used as input data. Our preliminary conclusion is that automatic location of relevant information is possible using medical reports as input data.
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Affiliation(s)
- J G Bellika
- Norwegian Centre for Telemedicine, University Hospital of Tromsø, Norway.
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