OBJECTIVES: While internship training is well established for medical records and for healthcare quality improvement, it is not quite so for training related to IT/health informatics. A comparison was made on the hospital-based IT/health informatics internship training received by students completing their training at the Imam AbdulRahman Bin Faisal University (IAU) in the Eastern province of Saudi Arabia. METHODS: The three hospitals studied all have the Joint Commission International accreditation and advanced Electronic Health Record (EHR) systems. Over the period from 2011 to 2015, interns from the IAU prepared 120 reports based on their training at these three hospitals. Data abstraction was done on the internship reports, and the results were summarized and interpreted. RESULTS: The study found wide differences in the training received at these hospitals. The main reason for the differences is whether or not the EHR system used in the hospital was a commercial one or developed in-house. CONCLUSIONS: The hospital that had developed its own EHR system made more use of health information management interns during their IT rotation in comparison to hospitals which had adopted commercial EHR systems. Recommendations are made of both local relevance and of international relevance.
Accreditation ; Clergy ; Electronic Health Records ; Health Information Management* ; Health Information Systems ; Humans ; Informatics ; Internship and Residency* ; Joints ; Medical Records ; Quality of Health Care ; Saudi Arabia* ; Tertiary Care Centers

OBJECTIVES: Controlling hospital high length of stay outliers can provide significant benefits to hospital management resources and lead to cost reduction. The strongest predictive factors influencing high length of stay outliers should be identified to build a high-performance prediction model for hospital outliers. METHODS: We highlight the application of the hierarchical genetic algorithm to provide the main predictive factors and to define the optimal structure of the prediction model fuzzy radial basis function neural network. To establish the prediction model, we used a data set of 26,897 admissions from five different intensive care units with discharges between 2001 and 2012. We selected and analyzed the high length of stay outliers using the trimming method geometric mean plus two standard deviations. A total of 28 predictive factors were extracted from the collected data set and investigated. RESULTS: High length of stay outliers comprised 5.07% of the collected data set. The results indicate that the prediction model can provide effective forecasting. We found 10 common predictive factors within the studied intensive care units. The obtained main predictive factors include patient demographic characteristics, hospital characteristics, medical events, and comorbidities. CONCLUSIONS: The main initial predictive factors available at the time of admission are useful in evaluating high length of stay outliers. The proposed approach can provide a practical tool for healthcare providers, and its application can be extended to other hospital predictions, such as readmissions and cost.
Comorbidity ; Data Mining ; Dataset ; Forecasting ; Health Personnel ; Humans ; Intensive Care Units ; Length of Stay* ; Machine Learning ; Medical Informatics ; Methods

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No abstract available.

OBJECTIVES: From the point of view of clinical data representation, this study attempted to identify obstacles in translating clinical narrative guidelines into computer interpretable format and integrating the guidelines with data in Electronic Health Records in China. METHODS: Based on SAGE and K4CARE formulism, a Chinese clinical practice guideline for hypertension was modeled in Protege by building an ontology that had three components: flowchart, node, and vMR. Meanwhile, data items imperative in Electronic Health Records for patients with hypertension were reviewed and compared with those from the ontology so as to identify conflicts and gaps between. RESULTS: A set of flowcharts was built. A flowchart comprises three kinds of node: State, Decision, and Act, each has a set of attributes, including data input/output that exports data items, which then were specified following ClinicalStatement of HL7 vMR. A total of 140 data items were extracted from the ontology. In modeling the guideline, some narratives were found too inexplicit to formulate, and encoding data was quite difficult. Additionally, it was found in the healthcare records that there were 8 data items left out, and 10 data items defined differently compared to the extracted data items. CONCLUSIONS: The obstacles in modeling a clinical guideline and integrating with data in Electronic Health Records include narrative ambiguity of the guideline, gaps and inconsistencies in representing some data items between the guideline and the patient' records, and unavailability of a unified medical coding system. Therefore, collaborations among various participants in developing guidelines and Electronic Health Record specifications is needed in China.
Asian Continental Ancestry Group ; China* ; Clinical Coding ; Cooperative Behavior ; Decision Support Systems, Clinical ; Delivery of Health Care ; Electronic Health Records ; Humans ; Hypertension ; Methods* ; Practice Guidelines as Topic ; Software Design ; Translating

OBJECTIVES: This paper describes a mobile Electronic Medical Record (EMR) platform designed to manage and utilize the existing EMR and mobile application with optimized resources. METHODS: We structured the mEMR to reuse services of retrieval and storage in mobile app environments that have already proven to have no problem working with EMRs. A new mobile architecture-based mobile solution was developed in four steps: the construction of a server and its architecture; screen layout and storyboard making; screen user interface design and development; and a pilot test and step-by-step deployment. This mobile architecture consists of two parts, the server-side area and the client-side area. In the server-side area, it performs the roles of service management for EMR and documents and for information exchange. Furthermore, it performs menu allocation depending on user permission and automatic clinical document architecture document conversion. RESULTS: Currently, Severance Hospital operates an iOS-compatible mobile solution based on this mobile architecture and provides stable service without additional resources, dealing with dynamic changes of EMR templates. CONCLUSIONS: The proposed mobile solution should go hand in hand with the existing EMR system, and it can be a cost-effective solution if a quality EMR system is operated steadily with this solution. Thus, we expect this example to be shared with hospitals that currently plan to deploy mobile solutions.
Electronic Health Records* ; Hand ; Information Storage and Retrieval ; Mobile Applications

OBJECTIVES: Diabetes is a chronic disease of continuously increasing prevalence. It is a disease with risks of serious complications, thus warranting its long-term management. However, current health management and education programs for diabetes mainly consist of one-way communication, and systematic social support backup to solve diabetics' emotional problems is insufficient. METHODS: According to individual behavioral changes based on the Transtheoretical Model, we designed a non-drug intervention, including exercise, and applied it to a mobile based application. For effective data sharing between patients and physicians, we adopted an SNS function for our application in order to offer a social support environment. RESULTS: To induce continual and comprehensive care for diabetes, rigorous self-management is essential during the diabetic's life; this is possible through a collaborative patient-physician healthcare model. We designed and developed an SNS-based diabetes self-management mobile application that supports the use of social groups, which are present in three social GYM types. With simple testing of patients in their 20s and 30s, we were able to validate the usefulness of our application. CONCLUSIONS: Mobile gadget-based chronic disease symptom management and intervention has the merit that health management can be conducted anywhere and anytime in order to cope with increases in the demand for health and medical services that are occurring due to the aging of the population and to cope with the surge of national medical service costs. This patient-driven and SNS-based intervention program is expected to contribute to promoting the health management habits of diabetics, who need to constantly receive health guidance.
Aging ; Chronic Disease ; Clinical Trial ; Delivery of Health Care ; Diabetes Mellitus ; Education ; Humans ; Information Dissemination ; Mobile Applications ; Prevalence ; Self Care* ; Telemedicine

OBJECTIVES: Utilizing social network analysis, this study aimed to analyze the main keywords in the literature regarding the health literacy of and the use of online health information by aged persons over 65. METHODS: Medical Subject Heading keywords were extracted from articles on the PubMed database of the National Library of Medicine. For health literacy, 110 articles out of 361 were initially extracted. Seventy-one keywords out of 1,021 were finally selected after removing repeated keywords and applying pruning. Regarding the use of online health information, 19 articles out of 26 were selected. One hundred forty-four keywords were initially extracted. After removing the repeated keywords, 74 keywords were finally selected. RESULTS: Health literacy was found to be strongly connected with 'Health knowledge, attitudes, practices' and 'Patient education as topic.' 'Computer literacy' had strong connections with 'Internet' and 'Attitude towards computers.' 'Computer literacy' was connected to 'Health literacy,' and was studied according to the parameters 'Attitude towards health' and 'Patient education as topic.' The use of online health information was strongly connected with 'Health knowledge, attitudes, practices,' 'Consumer health information,' 'Patient education as topic,' etc. In the network, 'Computer literacy' was connected with 'Health education,' 'Patient satisfaction,' 'Self-efficacy,' 'Attitude to computer,' etc. CONCLUSIONS: Research on older citizens' health literacy and their use of online health information was conducted together with study of computer literacy, patient education, attitude towards health, health education, patient satisfaction, etc. In particular, self-efficacy was noted as an important keyword. Further research should be conducted to identify the effective outcomes of self-efficacy in the area of interest.
Computer Literacy ; Consumer Health Information ; Education ; Health Education ; Health Literacy* ; Humans ; Internet ; Medical Subject Headings ; National Library of Medicine (U.S.) ; Patient Education as Topic ; Patient Satisfaction

OBJECTIVES: The aim of this study was to evaluate the effectiveness and sustainability of educational interventions to encourage incident reporting. METHODS: This was a quasi-experimental design. The study involved nurses working in two gastroenterology surgical wards at Fukuoka University Hospital, Japan. The number of participants on each ward was 26 nurses at baseline. For the intervention group, we provided 15 minutes of education about patient safety and the importance of incident reporting once per month for six months. After the completion of the intervention, we compared incident reporting in the subsequent 12 months for both groups. Questionnaires about reasons/motives for reporting were administered three times, before the intervention, after the intervention, and six months after the intervention for both the intervention group and the control group. RESULTS: For the intervention group, incident reporting during the 6 months after the intervention period increased significantly compared with the baseline. During the same period, the reasons and motives for reporting changed significantly in the intervention group. The increase in reported incidents during the 6- to 12-month period following the intervention was not significant. In the control group, there was no significant difference during follow-up compared with the baseline. CONCLUSIONS: A brief intervention about patient safety changed the motives for reporting incidents and the frequency of incidents reported by nurses working in surgical wards in a university hospital in Japan. However, the effect of the education decreased after six months following the education. Regular and long-term effort is required to maintain the effect of education.
Education* ; Follow-Up Studies ; Gastroenterology ; Japan* ; Patient Safety ; Risk Management ; Surveys and Questionnaires

OBJECTIVES: The purposes of this study were to develop a Web-based education program, My Child's Safety, which includes patient safety education and information on the diagnosis, treatment, and management for caregivers of children with cancer, and to examine the efficacy of the My Child's Safety program in promoting the caregivers' awareness of patient safety. METHODS: A one-group pre- and post-test design was adopted. The participants were the caregivers of children with cancer and were recruited from one pediatric hemato-oncology unit of a tertiary university hospital in a large metropolitan city of South Korea. They were asked to review the Web-based program for patient safety and then complete questionnaires developed to measure the awareness of patient safety among the caregivers. RESULTS: In the study, the total score of the caregivers' awareness of patient safety had increased significantly after Web-based self-learning patient safety education. Also caregivers' awareness of their right to ask and know about procedures and treatments during hospitalization had increased after the program was used. CONCLUSIONS: The Web-based patient safety education program effectively improved the awareness of patient safety and the awareness of the right to know and ask about procedures and treatments during hospitalization among the caregivers. Family caregivers were less likely to ask healthcare professionals questions related to safety.
Caregivers* ; Child* ; Delivery of Health Care ; Diagnosis ; Education ; Hospitalization ; Humans ; Korea ; Patient Safety ; Pediatrics ; Surveys and Questionnaires