healthcare information technology

  • 文章类型: Journal Article
    帕金森病(PD)是一种与年龄相关的神经退行性疾病,其特征是运动障碍,包括震颤,刚性,运动迟缓,和姿势不稳定。根据世界卫生组织,全球约有1%的人被诊断为PD,预计到2040年,这一数字将翻一番。PD的早期和准确诊断对于减缓疾病进展和减少长期残疾至关重要。由于疾病的复杂性,使用传统的临床测试很难准确诊断它。因此,有必要开发能够准确检测PD的智能诊断模型。本文介绍了一种新颖的混合方法,用于使用带有两个优化器的ANFIS准确预测PD,即亚当和PSO。ANFIS是一种用于非线性函数逼近和分类的模糊逻辑系统,虽然Adam优化器能够在每个训练步骤自适应地调整ANFIS中每个参数的学习率,这有助于模型更快地找到更好的解决方案。PSO是一种元启发式方法,灵感来自鸟类等社会动物的行为。与现有方法相比,组合这两种方法具有在PD诊断中提供改进的准确性和鲁棒性的潜力。所提出的方法利用了两种优化技术的优点,并将其应用于已开发的ANFIS模型,以最大程度地提高其预测精度。该系统是通过使用开放获取的临床和人口统计数据开发的。通过对比实验分析选择ANFIS的参数,以考虑模糊隶属度函数的数量来优化模型。ANFIS时代的数量,和粒子数的PSO。进一步详细分析和介绍了两种ANFIS模型的性能:ANFIS(Adam)和ANFIS(PSO),重点是ANFIS参数和各种评估指标,实验结果表明,提出的ANFIS(PSO)在损耗和精度方面都表现出更好的结果,然而,ANFIS(亚当)在准确性方面表现出更好的结果,F1-分数和召回。因此,这种自适应神经模糊算法为PD的诊断提供了一种有前途的策略,并表明所提出的模型显示了它们对许多其他实际应用的适用性。
    Parkinson\'s disease (PD) is an age-related neurodegenerative disorder characterized by motor deficits, including tremor, rigidity, bradykinesia, and postural instability. According to the World Health Organization, about 1 % of the global population has been diagnosed with PD, and this figure is expected to double by 2040. Early and accurate diagnosis of PD is critical to slowing down the progression of the disease and reducing long-term disability. Due to the complexity of the disease, it is difficult to accurately diagnose it using traditional clinical tests. Therefore, it has become necessary to develop intelligent diagnostic models that can accurately detect PD. This article introduces a novel hybrid approach for accurate prediction of PD using an ANFIS with two optimizers, namely Adam and PSO. ANFIS is a type of fuzzy logic system used for nonlinear function approximation and classification, while Adam optimizer has the ability to adaptively adjust the learning rate of each individual parameter in an ANFIS at each training step, which helps the model find a better solution more quickly. PSO is a metaheuristic approach inspired by the behavior of social animals such as birds. Combining these two methods has potential to provide improved accuracy and robustness in PD diagnosis compared to existing methods. The proposed method utilized the advantages of both optimization techniques and applied them on the developed ANFIS model to maximize its prediction accuracy. This system was developed by using an open access clinical and demographic data. The chosen parameters for the ANFIS were selected through a comparative experimental analysis to optimize the model considering the number of fuzzy membership functions, number of epochs of ANFIS, and number of particles of PSO. The performance of the two ANFIS models: ANFIS (Adam) and ANFIS (PSO) focusing at ANFIS parameters and various evaluation metrics are further analyzed in detail and presented, The experimental results showed that the proposed ANFIS (PSO) shows better results in terms of loss and precision, whereas, the ANFIS (Adam) showed the better results in terms of accuracy, f1-score and recall. Thus, this adaptive neural-fuzzy algorithm provides a promising strategy for the diagnosis of PD, and show that the proposed models show their suitability for many other practical applications.
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  • 文章类型: Journal Article
    在数字时代,电子病历(EMR)的无缝集成是医疗服务转型的关键里程碑,沙特阿拉伯站在中东这场革命的最前沿。这篇文献综述全面探讨了与沙特阿拉伯王国(KSA)采用EMR相关的挑战和机遇,以符合国家2030年愿景医疗保健目标。这篇综述综合了各种学术来源的研究,利用PubMed等数据库,Scopus,谷歌学者,和区域数据库,重点关注2010年至2023年出版的文献。我们的方法包括关键词的战略组合和严格的选择标准,以确保在KSA中关注相关的EMR采用研究。审查涉及EMR采用的关键方面,包括技术挑战,财政限制,人为因素,文化和组织障碍,隐私和安全问题,以及政策和监管挑战。它还探索了EMR与远程医疗等其他数字医疗计划的整合,个人健康记录,和社区药房服务。研究结果揭示了影响EMR采用的因素之间复杂的相互作用,强调需要解决技术问题的全面战略,金融,文化,和政策相关的障碍。审查的结论是,尽管存在重大挑战,针对沙特阿拉伯具体情况量身定制的战略方法和解决方案可以有效促进EMR整合,从而提高医疗保健质量和效率,符合国家2030年愿景目标。
    In the digital era, the seamless integration of electronic medical records (EMR) stands as a pivotal milestone in transforming healthcare delivery, with Saudi Arabia at the forefront of this revolution in the Middle East. This literature review comprehensively explores the challenges and opportunities associated with adopting EMR in the Kingdom of Saudi Arabia (KSA) in alignment with the nation\'s Vision 2030 healthcare objectives. The review synthesizes research from various scholarly sources, utilizing databases such as PubMed, Scopus, Google Scholar, and regional databases, and focuses on literature published between 2010 and 2023. Our methodology included a strategic combination of keywords and a stringent selection criterion to ensure a focus on relevant EMR adoption studies within KSA. The review addresses key aspects of EMR adoption, including technical challenges, financial constraints, human factors, cultural and organizational barriers, privacy and security concerns, and policy and regulatory challenges. It also explores the integration of EMR with other digital health initiatives like telehealth, personal health records, and community pharmacy services. The findings reveal a complex interplay of factors influencing EMR adoption, highlighting the need for comprehensive strategies that address technical, financial, cultural, and policy-related barriers. The review concludes that while significant challenges exist, strategic approaches and solutions tailored to the specific context of Saudi Arabia can effectively facilitate EMR integration, thereby enhancing healthcare quality and efficiency in line with the nation\'s Vision 2030 goals.
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  • 文章类型: Journal Article
    对与医疗保健信息技术(HIT)相关联的错误的感知通常取决于观看者的上下文和位置。HIT供应商认为错误的原因与临床医生非常不同,实施团队,或IT人员。即使在同一家医院里,部门和服务的成员经常牵连其他部门。组织可能会将错误归因于转诊患者的外部护理合作伙伴,如疗养院或诊所外。此外,组织内的各种临床角色(例如,医师,护士,药剂师)可以不同地概念化错误及其根本原因。支配所有这些感知因素,定义,机制,与HIT相关的错误的发生率是非常矛盾的。定义或计算这些错误都没有通用标准。本文试图列举和阐明与HIT相关的医疗错误的差异认知相关的问题。然后提出解决方案。
    Perceptions of errors associated with healthcare information technology (HIT) often depend on the context and position of the viewer. HIT vendors posit very different causes of errors than clinicians, implementation teams, or IT staff. Even within the same hospital, members of departments and services often implicate other departments. Organizations may attribute errors to external care partners that refer patients, such as nursing homes or outside clinics. Also, the various clinical roles within an organization (e.g., physicians, nurses, pharmacists) can conceptualize errors and their root causes differently. Overarching all these perceptual factors, the definitions, mechanisms, and incidence of HIT-related errors are remarkably conflictual. There is neither a universal standard for defining or counting these errors. This paper attempts to enumerate and clarify the issues related to differential perceptions of medical errors associated with HIT. It then suggests solutions.
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  • 文章类型: Case Reports
    未经批准:作为FDA的DSCSA试点项目计划的一部分,加州大学洛杉矶分校及其解决方案合作伙伴,LedgerDomain(以下统称为团队),专注于建立一个完整的,基于区块链的工作系统,BRUINchain,这将满足药品供应链安全法案(DSCSA)的所有关键目标,用于仅使用商业现成(COTS)技术操作的分配器。
    UNASSIGNED:BRUINchain系统要求包括扫描药物包装以获取格式正确的2D条形码,标记过期产品,向制造商验证产品,在最后一英里隔离可疑和非法产品:药剂师对病人,药品供应链中最复杂的领域。作者展示了一个成功的实施,其中产品跟踪通知自动发送给关键利益相关者,提高了及时性,减轻了文书工作负担。这项工作的核心是基于区块链的解决方案,以跟踪和追踪药物保管方面的变化。作为一个不可变的,时间戳,近实时(50毫秒延迟),可审计的交易记录,BRUINchain使供应链社区有可能获得单一版本的真相。BRUINchain在美国最繁忙的药店之一使用真实护理人员向真实患者提供救生药物的真实数据进行了测试。
    UNASSIGNED:除了直接与制造商沟通以进行验证之外,BRUINchain还启动了可疑产品通知。在研究期间,观察到100%的扫描成功率,过期检测,和伪造检测;文书工作从大约1小时减少到不到一分钟。
    UNASSIGNED:通过使用我们基于区块链的系统自动询问制造商的关系数据库,我们的结果表明,预计DSCSA合规成本为每台17美分,而且可能更多取决于监管解释和验证速度。我们预计,通过制造商采用高性能产品,可以降低成本,基于数字分类帐技术(DLT)的全自动端到端系统。在检查这种系统的互操作性时,我们详细阐述了它能够实时验证而不会让人类陷入困境的能力,推动降低合规成本的关键功能。美国每年发放42亿张处方,DLT不仅将预计的单位成本降低到每单位13美分(每年节省1.83亿美元的劳动力成本),但也是防止不良或欺诈交易的主要堡垒,减少对安全库存的需求,并加强对药品供应链中潜在危险药物的检测和清除,以保护美国消费者。
    UNASSIGNED: As part of the FDA\'s DSCSA Pilot Project Program, UCLA and its solution partner, LedgerDomain (collectively referred to as the team hereafter), focused on building a complete, working blockchain-based system, BRUINchain, which would meet all the key objectives of the Drug Supply Chain Security Act (DSCSA) for a dispenser operating solely on commercial off-the-shelf (COTS) technology.
    UNASSIGNED: The BRUINchain system requirements include scanning the drug package for a correctly formatted 2D barcode, flagging expired products, verifying the product with the manufacturer, and quarantining suspect and illegitimate products at the last mile: pharmacist to patient, the most complex area of the drug supply chain.The authors demonstrate a successful implementation where product-tracing notifications are sent automatically to key stakeholders, resulting in enhanced timeliness and reduction in paperwork burden. At the core of this effort was a blockchain-based solution to track and trace changes in custody of drug. As an immutable, time-stamped, near-real-time (50-millisecond latency), auditable record of transactions, BRUINchain makes it possible for supply chain communities to arrive at a single version of the truth. BRUINchain was tested using real data on real caregivers administering life-saving medications to real patients at one of the busiest pharmacies in the United States.
    UNASSIGNED: In addition to communicating with the manufacturer directly for verification, BRUINchain also initiated suspect product notifications. During the study, a 100% success rate was observed for scanning, expiration detection, and counterfeit detection; and paperwork reduction from approximately 1 hour to less than a minute.
    UNASSIGNED: By automatically interrogating the manufacturer\'s relational database with our blockchain-based system, our results indicate a projected DSCSA compliance cost of 17 cents per unit, and potentially much more depending on regulatory interpretation and speed of verification. We project that this cost could be reduced with manufacturers\' adoption of a highly performant, fully automated end-to-end system based on digital ledger technology (DLT). During an examination of the interoperability of such a system, we elaborate on its capacity to enable verification in real time without keeping humans in the loop, the key feature driving lower compliance cost. With 4.2 billion prescriptions being dispensed each year in the United States, DLT would not only reduce the projected per-unit cost to 13 cents per unit (saving $183 million in annual labor costs), but also serve as a major bulwark against bad or fraudulent transactions, reduce the need for safety stock, and enhance the detection and removal of potentially dangerous drugs from the drug supply chain to protect US consumers.
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  • 文章类型: Journal Article
    UNASSIGNED: Health organizations increasingly digitize. However, studies reveal contradictory findings regarding the impact of healthcare information technology on health professionals. Therefore, the aim of this study is to describe the prevalence of technostress among health professionals and elaborate on the influencing factors.
    UNASSIGNED: A secondary analysis was conducted utilizing cross-sectional data from the study, \"Work-related stress among health professionals in Switzerland\", which included 8,112 health professionals from 163 health organizations in Switzerland.
    UNASSIGNED: ANOVA for group comparisons followed by post-hoc analyses, along with a Multilevel Model to identify influencing factors for technostress ranging from \"0\" (never/almost never) to \"100\" (always), were conducted.
    UNASSIGNED: Health professionals experienced moderate technostress (mean 39.06, SD 32.54). Technostress differed between settings (p <.001) and health professions (p < .001). The model explains 18.1% of the variance with fixed effects, or 24.7% of the variance with fixed and random effects. Being a physician (β = 12.96), a nurse (β = 6.49), or the presence of an effort-reward-imbalance, increased technostress most (β = 6.11). A professional with no professional qualification (β = -7.94) showed the most reduction.
    UNASSIGNED: Health professionals experience moderate technostress. However, decision-makers should consider the cognitive and social aspects surrounding digitalization, to reach a beneficial and sustainable level of usage.
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  • 文章类型: Journal Article
    OBJECTIVE: Mobile health (m-Health) technologies may provide an appropriate follow-up support service for patient groups with post-treatment conditions. While previous studies have introduced m-Health methods for patient care, a smart system that may provide follow-up communication and decision support remains limited to the management of a few specific types of diseases. This paper introduces an m-Health solution in the current climate of increased demand for electronic information exchange.
    METHODS: Adopting a novel design science research approach, we developed an innovative solution model for post-treatment follow-up decision support interaction for use by patients and physicians and then evaluated it by using convergent interviewing and focus group methods.
    RESULTS: The cloud-based solution was positively evaluated as supporting physicians and service providers in providing post-treatment follow-up services. Our framework provides a model as an artifact for extending care service systems to inform better follow-up interaction and decision-making.
    CONCLUSIONS: The study confirmed the perceived value and utility of the proposed Clinical Decision Support artifact indicating that it is promising and has potential to contribute and facilitate appropriate interactions and support for healthcare professionals for future follow-up operationalization. While the prototype was developed and tested in a developing country context, where the availability of doctors is limited for public healthcare, it was anticipated that the prototype would be user-friendly, easy to use, and suitable for post-treatment follow-up through mobility in remote locations.
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  • 文章类型: Journal Article
    The ability of nurses to adopt and successfully use EMR is expected to have a significant impact on achieving benefits such as reduction in healthcare costs and improvement in healthcare quality. A review of the current research literature reveals issues and concerns relating to the adoption and use of EMR by nurses in hospital environments. This article presents a literature review of such issues and concerns, and suggests a framework for enhancing the adoption and use of EMR by nurses and hospitals.
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    文章类型: Journal Article
    In order to improve the quality and performance of healthcare services, healthcare information technology is among the most important technology in healthcare supply chain management. This study sets out to apply and test the Unified Theory of Acceptance and Use of Technology (UTAUT), to examine the factors influencing healthcare Information Technology (IT) services. A structured questionnaire was developed and distributed to healthcare representatives in each province surveyed in Thailand. Data collected from 400 employees including physicians, nurses, and hospital staff members were tested the model using structural equation modeling technique. The results found that the factors with a significant effect are performance expectancy, effort expectancy and facilitating conditions. They were also found to have a significant impact on behavioral intention to use the acceptance healthcare technology. In addition, in Thai provincial areas, positive significance was found with two factors: social influence on behavioral intention and facilitating conditions to direct using behavior. Based on research findings, in order for healthcare information technology to be widely adopted and used by healthcare staffs in healthcare supply chain management, the healthcare organizational management should improve healthcare staffs\' behavioral intention and facilitating conditions.
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  • 文章类型: Journal Article
    Task and error analysis research was performed to identify: a) the process for healthcare organisations in managing healthcare for patients with mental illness or substance abuse; b) how the process can be enhanced and; c) if electronic medical records (EMRs) have a role in this process from a business and safety perspective. The research question is if EMRs have a role in enhancing the healthcare for patients with mental illness or substance abuse. A discussion on the business of EMRs is addressed to understand the balancing act between the safety and business aspects of an EMR.
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  • 文章类型: Journal Article
    卫生与人类服务部部长(HHS)通过食品和药物管理局(FDA)采取行动,并与联邦通信委员会(FCC)和国家卫生信息技术协调员办公室(ONC)合作,基于风险的卫生信息技术(IT)监管框架。在卫生信息技术政策委员会的主持下成立了一个专家利益相关者小组,以帮助为该框架的开发提供投入,包括如何在风险方面对医疗保健IT系统进行分层,并建议如何调整当前的监管要求。在本文中,我们总结了专家利益相关者小组的公开讨论和最终公开报告,并提出旨在解决收费的关键建议,以推荐基于风险的监管框架的特征,以促进创新,保护患者安全,并避免监管重复。
    The Secretary of Health and Human Services (HHS) acting through the Food and Drug Administration (FDA), and in collaboration with the Federal Communications Commission (FCC) and Office of the National Coordinator for Health IT (ONC) was tasked with delivering a report on an appropriate, risk-based regulatory framework for health information technology (IT). An expert stakeholder group was established under the auspices of the Health IT Policy Committee to help provide input into the development of this framework, including how healthcare IT systems could be stratified in terms of risk and recommendations about how the regulatory requirements currently in place should be adapted. In this paper, we summarize the public deliberations and final public report of the expert stakeholder group, and conclude with key suggestions intended to address the charge to recommend the features of a risk-based regulatory framework that promote innovation, protect patient safety, and avoid regulatory duplication.
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