Health Information Systems

健康信息系统
  • 文章类型: Journal Article
    背景:常规健康信息系统(RHIS)是为有关医疗机构绩效的决策和行动提供信息的重要数据来源,但RHIS数据在中低收入国家的使用往往是有限的。影响RHIS数据知情决策和行动的决定因素尚未得到很好的理解,很少有研究探讨RHIS数据知情决策和行动之间的关系。
    方法:这项定性主题分析研究探讨了莫桑比克在卫生机构一级成功的RHIS数据知情行动的决定因素和特征,以及哪些决定因素受到综合地区证据行动(IDEA)战略的影响。2019年和2020年通过27次深度访谈和7次焦点小组讨论,收集了两轮定性数据,参与IDEA的地区和医疗机构一级管理人员和一线卫生工作者加强了审计和反馈策略。常规信息系统管理法案框架的绩效指导了数据收集工具和主题分析的开发。
    结果:将RHIS数据转化为行动的关键行为决定因素包括卫生工作者对卫生机构绩效指标的理解和认识,以及卫生工作者提高卫生机构绩效的主人翁意识和责任感。监督,强调在职支持以及财政和人力资源的可用性是制定和执行行动计划的重要组织决定因素。论坛定期开会,作为一个小组进行审查,研究参与者强调讨论和监测医疗机构绩效是一个关键的决定因素.
    结论:未来的数据到行动干预和研究应考虑在上下文中可行的方法,以支持医疗机构和地区管理人员定期举行会议进行审查,讨论和监测医疗机构的绩效,以促进RHIS数据转化为行动。
    BACKGROUND: Routine health information systems (RHISs) are an essential source of data to inform decisions and actions around health facility performance, but RHIS data use is often limited in low and middle-income country contexts. Determinants that influence RHIS data-informed decisions and actions are not well understood, and few studies have explored the relationship between RHIS data-informed decisions and actions.
    METHODS: This qualitative thematic analysis study explored the determinants and characteristics of successful RHIS data-informed actions at the health facility level in Mozambique and which determinants were influenced by the Integrated District Evidence to Action (IDEAs) strategy. Two rounds of qualitative data were collected in 2019 and 2020 through 27 in-depth interviews and 7 focus group discussions with provincial, district and health facility-level managers and frontline health workers who participated in the IDEAs enhanced audit and feedback strategy. The Performance of Routine Information System Management-Act framework guided the development of the data collection tools and thematic analysis.
    RESULTS: Key behavioural determinants of translating RHIS data into action included health worker understanding and awareness of health facility performance indicators coupled with health worker sense of ownership and responsibility to improve health facility performance. Supervision, on-the-job support and availability of financial and human resources were highlighted as essential organisational determinants in the development and implementation of action plans. The forum to regularly meet as a group to review, discuss and monitor health facility performance was emphasised as a critical determinant by study participants.
    CONCLUSIONS: Future data-to-action interventions and research should consider contextually feasible ways to support health facility and district managers to hold regular meetings to review, discuss and monitor health facility performance as a way to promote translation of RHIS data to action.
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  • 文章类型: Journal Article
    背景:作为一个新出现的概念和二十一世纪的产物,卫生信息治理正在迅速扩展。医疗行业信息治理的必要性是显而易见的,鉴于健康信息的重要性和当前管理它的需求。本范围审查的目的是确定健康信息治理的维度和组成部分,以发现这些因素如何影响医疗保健系统和服务的增强。
    方法:PubMed,Scopus,WebofScience,ProQuest和GoogleScholar搜索引擎从开始到2024年6月进行了搜索。方法学研究质量使用CASP清单对选定的文件进行评估。尾注20用于选择和审查文章和管理参考资料,MAXQDA2020用于内容分析。
    结果:共37份文件,包括18次审查,9项定性研究和10项混合方法研究,通过文献检索确定。根据调查结果,六个核心类别(包括卫生信息治理目标,优势和应用,原则,组件或元素,角色、责任和流程)和48个子类别被确定,以形成一个统一的总体框架,包括所有提取的维度和组件。
    结论:根据本范围审查的结果,卫生信息治理应被视为各国卫生系统改善和实现目标的必要条件,特别是在发展中国家和不发达国家。此外,鉴于2019年冠状病毒病(COVID-19)大流行在不同国家的不良影响,组织健康信息治理模型的开发和实施,国家和国际层面是紧迫的关切。研究人员可以将当前的发现用作开发健康信息治理模型的综合模型。这项研究的一个可能的限制是我们对某些数据库的访问有限。
    BACKGROUND: As a newly emerged concept and a product of the twenty-first century, health information governance is expanding at a rapid rate. The necessity of information governance in the healthcare industry is evident, given the significance of health information and the current need to manage it. The objective of the present scoping review is to identify the dimensions and components of health information governance to discover how these factors impact the enhancement of healthcare systems and services.
    METHODS: PubMed, Scopus, Web of Science, ProQuest and the Google Scholar search engine were searched from inception to June 2024. Methodological study quality was assessed using CASP checklists for selected documents. Endnote 20 was utilized to select and review articles and manage references, and MAXQDA 2020 was used for content analysis.
    RESULTS: A total of 37 documents, including 18 review, 9 qualitative and 10 mixed-method studies, were identified by literature search. Based on the findings, six core categories (including health information governance goals, advantages and applications, principles, components or elements, roles and responsibilities and processes) and 48 subcategories were identified to form a unified general framework comprising all extracted dimensions and components.
    CONCLUSIONS: Based on the findings of this scoping review, health information governance should be regarded as a necessity in the health systems of various countries to improve and achieve their goals, particularly in developing and underdeveloped countries. Moreover, in light of the undesirable effects of the coronavirus disease 2019 (COVID-19) pandemic in various countries, the development and implementation of health information governance models at organizational, national and international levels are among the pressing concerns. Researchers can use the present findings as a comprehensive model for developing health information governance models. A possible limitation of this study is our limited access to some databases.
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  • 文章类型: Journal Article
    UNASSIGNED: Occupational accidents represent a severe and complex public health issue.
    UNASSIGNED: To identify temporal trends in occupational mortality in Brazil from 2010 to 2019.
    UNASSIGNED: This was an ecological study with time series analysis using data from the Brazilian Ministry of Health Mortality Information System (Ministério da Saúde/ Sistema de Informações sobre Mortalidade). The mortality rate was calculated using Prais-Winsten estimation.
    UNASSIGNED: In the study period, 34,683 work-related deaths were recorded in Brazil, with a higher occurrence among White (51.0%) men (94.3%) aged 20 to 39 years (44.8%). The highest proportion of deaths (16.5%) was identified in the state of São Paulo. Regarding sex, temporal trends were stable for both men (annual percentage change [APC] = -1.7; 95%CI -3.9 to 0.7) and women (APC = -0.8; 95%CI -1.8 to 0.2). The age groups up to 19 years (APC = -5.1; 95%CI -9.0 to l.l) and 20 to 39 years (APC = -3.3; 95%CI -6.0 to -0.5) showed a decreasing trend, while the remaining age groups showed a stable trend. Black race had a decreasing trend (APC = -8.1; 95%CI -10.7 to -5.5), while White (APC = -2.3; 95%CI -38.0 to 0.2) and mixed races (APC = -1.2; 95%CI -5.2 to 2.9) had a stable trend. Eight states showed a decreasing trend; only the state of Pará (APC = 2.1; 95%CI 0.8 to 3.4) showed an increasing trend, while the other states had a stable trend.
    UNASSIGNED: Temporal trends in occupational mortality were stable for most of the indicators evaluated. There is a lack of measures contributing to occupational safety and health in Brazil.
    UNASSIGNED: Acidentes de trabalho representam um grave e complexo problema de saúde pública. Objetivos: Analisar a tendência temporal da mortalidade por acidentes de trabalho no Brasil no período de 2010 a 2019.
    UNASSIGNED: Estudo ecológico de séries temporais, com dados do Sistema de Informações sobre Mortalidade. Calculou-se a taxa de mortalidade utilizando regressão de Prais-Winsten.
    UNASSIGNED: Foram registrados 34.683 óbitos decorrentes de acidentes de trabalho no país, com maior ocorrência no sexo masculino (94,3%), na faixa etária de 20 a 39 anos (44,8%) e na raça branca (51,0%). A maior proporção de óbitos foi identificada no estado de São Paulo (16,5%). A tendência temporal apresentou estabilidade no sexo masculino (variação percentual anual (VPA) = -1,7; IC95% -3,9 a 0,7) e feminino (VPA = -0,8; IC95% -1,8 a 0,2). A tendência revelou decréscimo nas faixas etárias de até 19 anos (VPA = -5,1; IC95% -9,0 a 1,1) e de 20 a 39 anos (VPA = -3,3; IC95% -6,0 a -0,5), enquanto as demais faixas apresentaram estabilidade. A raça preta apresentou decréscimo (VPA = -8,1; IC95% -10,7 a -5,5), enquanto a branca (VPA = -2,3; IC95% -38,0 a 0,2) e a parda (VPA = -1,2; IC95% -5,2 a 2,9) apresentaram estabilidade. Oito unidades da federação apresentaram decréscimo; apenas o estado do Pará (VPA = 2,1; IC95% 0,8 a 3,4) apresentou acréscimo, enquanto as demais unidades registraram estabilidade.
    UNASSIGNED: A tendência temporal da taxa de mortalidade apresentou estabilidade na maior parte dos indicadores avaliados. Percebe-se a carência de discussões que possam contribuir com ações no campo da segurança e saúde no trabalho.
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  • 文章类型: Journal Article
    我们的目标是利用瑞典东南部当地卫生服务提供商维护的数字平台,综合监测COVID-19大流行期间疫苗接种和发病率的差异。这项监测是在2020年2月1日至2022年2月15日期间对两个县(n=657,926)的成年人口进行的。被监测的差距被重新安置(国际流离失所者),物质使用者,患有精神病.监测的结果是COVID-19疫苗接种,SARS-CoV-2测试结果,和COVID-19住院。与普通人群相比,搬迁居民未接种疫苗的可能性增加,检测的可能性降低,原发性SARS-CoV-2感染和住院的风险增加。患有重大精神疾病与未接种疫苗的风险增加和住院风险增加有关,但SARS-CoV-2感染的风险降低。从数字监控,我们得出的结论是,在大流行期间,搬迁的少数民族得到的保护不足,提出了全面推进社会整体融合的必要性。患有重大精神疾病的人未充分接种疫苗,虽然他们从主动提供的测试中受益,这意味着需要积极鼓励接种疫苗。需要进一步研究疫苗接种计划中数字监控的法律和道德框架。
    We aimed to use the digital platform maintained by the local health service providers in Southeast Sweden for integrated monitoring of disparities in vaccination and morbidity during the COVID-19 pandemic. The monitoring was performed in the adult population of two counties (n = 657,926) between 1 February 2020 and 15 February 2022. The disparities monitored were relocated (internationally displaced), substance users, and suffering from a psychotic disorder. The outcomes monitored were COVID-19 vaccination, SARS-CoV-2 test results, and hospitalization with COVID-19. Relocated residents displayed an increased likelihood of remaining unvaccinated and a decreased likelihood of testing as well as increased risks of primary SARS-CoV-2 infection and hospitalization compared with the general population. Suffering from a major psychiatric disease was associated with an increased risk of remaining unvaccinated and an increased risk of hospitalization but a decreased risk of SARS-CoV-2 infection. From the digital monitoring, we concluded that the relocated minority received insufficient protection during the pandemic, suggesting the necessity for comprehensive promotion of overall social integration. Persons with major psychiatric diseases underused vaccination, while they benefitted from proactively provided testing, implying a need for active encouragement of vaccination. Further research is warranted on legal and ethical frameworks for digital monitoring in vaccination programs.
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  • 文章类型: Journal Article
    背景:麻风病,一种被忽视的热带病,据报道,在120多个国家,每年有超过20万例新病例。这项横断面队列研究旨在描绘巴西南部低流行地区麻风病的流行病学特征。在实施主动搜索策略之前和之后。
    方法:该研究检查了卡萨多的两个监测期,圣卡塔琳娜,巴西。主动搜索策略是通过社区卫生工作者将LSQ用作麻风病新病例的筛查和检测工具来实施的,并将其与被动病例检测进行了比较。第一次从2014年到2020年,第二次从2021年1月到2023年8月。
    结果:在整个研究中报告了48例麻风病病例,其中83.3%被诊断为多杆菌。第一期平均检出率为每1万居民0.38例,在第二阶段,每10000名居民增加1.19例。值得注意的是,身体残疾(GD)的程度发生了重大变化,有更多0级和1级残疾的人观察到了活动后的搜索。
    结论:该研究强调了主动搜索策略在早期诊断中的有效性,突出显示诊断病例的年平均水平增加了300%。检测到的大量病例证明了LSQ的高灵敏度。这种方法大大有助于发现隐藏的麻风病病例,加强低流行地区的疾病管理和控制,表明卫生部应加强这些地区的麻风病控制活动。
    BACKGROUND: Leprosy, a neglected tropical disease, is reported in over 120 countries, with upwards of 200,000 new cases annually. This Cross-Sectional Cohort Study aimed to delineate the epidemiological profile of leprosy in a low-endemic area in southern Brazil, both before and after implementing an active search strategy.
    METHODS: The study examined two surveillance periods in Caçador, Santa Catarina, Brazil. The active search strategy was carried out through the application of the LSQ by the community health workers as a screening and detection tool for new cases of leprosy and this was compared with passive case detection. The first spanned from 2014 to 2020, and the second from January 2021 to August 2023.
    RESULTS: 48 leprosy cases were reported throughout the study, 83.3 % of which were diagnosed as multibacillary. The first period had an average detection rate of 0.38 cases per 10,000 inhabitants, increasing to 1.19 cases per 10,000 inhabitants in the second period. Notably, there was a substantial shift in the degree of physical disability (GD), with more Grade 0 and Grade 1 disabilities observed post-active search.
    CONCLUSIONS: The study underscores the efficacy of active search strategies in early diagnosis, highlighting a 300 % increase in the annual average of diagnosed cases. This large number of detected cases demonstrates the high sensitivity of the LSQ. This approach significantly aids in uncovering hidden cases of leprosy, enhancing disease management and control in low-endemic areas indicating that the Ministry of Health should intensify leprosy control activities in these regions.
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  • 文章类型: Journal Article
    在信息技术迅速发展的环境中,个人和组织必须适应数字时代。鉴于用户知识和技术经验的多样性,他们的接受程度也各不相同。在过去的30年里,引入了各种理论模型,为理解用户对技术的接受度提供了一个框架。其中,技术接受模型(TAM)是一个关键的理论框架,提供洞察为什么新技术被接受或拒绝。因此,分析用户对技术的接受度已成为研究的关键领域。医疗保健组织旨在评估给定技术的感知功效和用户友好性。这将有助于卫生组织设计和实施满足用户需求和偏好的HIS。在这种情况下,TAM如何澄清对健康信息系统(HIS)的接受和使用?为了解决这个问题,将进行全面的文献综述。系统评价涉及2018年至2023年之间发布的29项研究,并搜索了Pubmed数据库,Scopus,Wos和UlakbimTR指数。PRISMA流程图用于确定纳入的研究。根据结果,一些变量在HIS的接受和利用中脱颖而出。在HIS的用户中,可以说,与护士有关的结果脱颖而出。特别是,有研究强调,“性别”是解释模型的关键因素。当前系统审查的另一个重要发现是需要培训用户接受和使用HIS。
    In the rapidly evolving landscape of information technologies, individuals and organizations must adapt to the digital age. Given the diversity in users\' knowledge and experience with technology, their acceptance levels also vary. Over the past 30 years, various theoretical models have been introduced to provide a framework for understanding user acceptance of technology. Among these, the Technology Acceptance Model (TAM) stands out as a key theoretical framework, offering insights into why new technologies are either accepted or rejected. Analyzing user acceptance of technology has thus become a critical area of study. Healthcare organizations aim to assess the perceived efficacy and user-friendliness of a given technology. This will help health organisations design and implement HIS that meet users\' needs and preferences. In this context, how does the TAM clarify the acceptance and use of Health Information Systems (HIS)? To address this inquiry, a comprehensive literature review will be carried out. The systematic review involved 29 studies issued between 2018 and 2023 and searched the databases Pubmed, Scopus, Wos and Ulakbim TR Index. The PRISMA flowchart was used to identify the included studies. According to the results, some variables stand out in the acceptance and utilisation of HIS. Among the users of HIS, it can be said that the results relating to nurses stand out. In particular, there are studies which emphasise that \'gender\' is a crucial factor in explaining the models. Another crucial finding of the current systematic review is the need to train users in the acceptance and use of HIS.
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  • 文章类型: Journal Article
    在提供以患者为中心的护理以满足人口老龄化需求的背景下,研究了缺乏标准化组织指导的问题。在追求公平和及时的医疗保健服务方面,整个综合组织的标准化越来越被视为社会正义问题。特别是当医疗保健行业努力应对美国严重的护理短缺时。测试了主项目计划方法(MPPM),以使用系统开发生命周期(SDLC)框架有效地开发电子年龄友好型4M文档工具。MPPM成功指导了设计和国家实施,在美国最大的综合医疗保健系统之一的124个设施中实现84%的安装率。
    The issue of lacking standardized organizational guidance is examined in the context of providing patient-centered care to meet the needs of an aging population. Standardization across an integrated organization is increasingly recognized as a social justice concern in the pursuit of equitable and timely healthcare delivery, particularly as the healthcare industry grapples with a severe nursing shortage in the United States. A master project plan methodology (MPPM) was tested to effectively develop an electronic Age-Friendly 4Ms documentation tool using the system development lifecycle (SDLC) framework. The MPPM successfully guided the design and national implementation, achieving an 84% installation rate across 124 facilities within one of America\'s largest integrated healthcare systems.
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  • 文章类型: Journal Article
    围绕性别/性别二元组合的数字健康信息系统的设计导致了健康不平等。缺乏支持确认沟通的具体信息会导致不适当的护理,与医护人员的无礼接触,以及因性别错误而受到伤害的客户避免提供医疗服务,死名和被曝光。HL7国际性别和谐模型(HL7GHM)支持该设计,DHIS的实施和使用,能够确认临床互动和护理。本案例研究将展示应用HL7GHM如何解决加拿大一名患者最近发表的报道中报告的危害。
    The design of digital health information systems around a conflated gender/sex binary contributes to health inequities. Lack of specific information that supports affirming communication lead to inappropriate care, disrespectful encounters with healthcare staff, and avoidance of health services by clients who have been harmed by misgendering, deadnaming and being outed. The HL7 International Gender Harmony Model (HL7 GHM) supports the design, implementation and use of DHIS that enable affirming clinical interactions and care. This case study will demonstrate how applying the HL7 GHM can address the harms reported in a recently published account of one patient in Canada.
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  • 文章类型: Journal Article
    持牌实践护士(LPN)是芬兰第二大职业群体,也是社会和医疗保健领域最大的群体。他们有广泛的工作环境。像其他健康和社会护理专业人员一样,LPN在日常工作中还使用健康信息系统(HIS)和客户信息系统(CIS)。这项研究的目的是描述LPN对信息系统在日常患者护理中的益处的看法。信息系统包括受访者在工作中主要使用的主要HISorCIS。数据包括3866个LPN响应,是通过2022年的在线调查收集的。大多数LPN使用Lifecare系统在社会护理中工作。ESKO用于公共医疗保健,并被评为LPN在信息系统的好处方面使用的最受欢迎的系统。经验丰富的LPN似乎比刚刚开始工作的LPN对信息系统的收益评价更高。
    Licensed practical nurses (LPNs) are the second largest occupational group and the largest group in the social and healthcare sector in Finland, and they have an extensive working environment. Like other health and social care professionals, LPNs also use health information systems (HIS) and client information systems (CIS) in their daily work. The aim of this study was to describe LPNs\' perceptions of the benefits of information systems in daily patient care. The information systems include the main HIS or CIS that the respondents mainly use in their work. The data comprised 3 866 LPNs\' responses were collected via an online survey in 2022. Most of the LPNs work in social care using the Lifecare system. ESKO is used in public health care and was rated as the most popular system that LPNs use regarding the benefits of information systems. Highly experienced LPNs seem to rate the benefits of information systems higher than LPNs who have just started working.
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  • 文章类型: English Abstract
    有效的健康信息系统(HIS)确保生产,分析,传播和使用关于健康决定因素的可靠和最新信息。然而,它可能会遇到阻碍其运作的障碍,如武装冲突,这限制了医疗服务的获取和质量。我们研究的目的是在安全危机期间帮助改善廷巴克图卫生区常规卫生信息系统的数据管理。
    我们进行了描述性横断面研究,2023年4月15日至9月8日,廷巴克图卫生区的健康信息管理专业人员中。使用EpiInfo7.2.2版分析从调查问卷获得的数据。并使用MicrosoftWord和Excel2016进行处理。
    共调查了6个医疗机构。数据收集,分析和反馈非常差。数据质量100%完整,92.40%提示和68.11%准确。主要制约因素是:SIS的卫生工作者参与度低(22.22%),对SISR的培训不足(29.63%),监督(47.06%),互联网无法访问(66.67%),卫生机构的不安全感(37.04%)和恐惧感(61.76%)。
    我们的结果显示了低级工艺,网络覆盖差,缺乏合格的健康信息管理专业人员,越来越不安全。更广泛的混合方法研究将提供更好的理解。
    UNASSIGNED: an effective health information system (HIS) ensures the production, analysis, dissemination and use of reliable and up-to-date information on the determinants of health. However, it can encounter obstacles that hinder its functioning, such as armed conflicts, which limit access and quality of healthcare services. The purpose of our study was to help improve data management for routine health information system in the health district of Timbuktu during a security crisis.
    UNASSIGNED: we conducted a descriptive cross-sectional study, among health information management professionals in the Timbuktu Health District from 15 April to 08 September 2023. Data obtained from a survey questionnaire were analyzed using Epi Info version 7.2.2. and processed using Microsoft Word and Excel 2016.
    UNASSIGNED: a total of 6 health facilities were surveyed. Data collection, analysis and feedback were very poor. Data quality was 100% complete, 92.40% prompt and 68.11% accurate. The major constraints were: low involvement of health workers in the SIS (22.22%), insufficient training on the SISR (29.63%), supervision (47.06%), internet inaccessibility (66.67%), feeling of insecurity (37.04%) and fear (61.76%) in health facilities.
    UNASSIGNED: our results show low-level processes, poor network coverage, shortage of qualified health information management professionals and increasing insecurity. A broader mixed-methods research would provide a better understanding.
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