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JMIR Medical Informatics

Amirabbas Azizi, Robab Aboutorabi, Zahra Mazloum-Khorasani, Monavar Afzal-Aghaea, Hamed Tabesh, Mahmood Tara
BACKGROUND: There are 4 main types of chronic or noncommunicable diseases. Of these, diabetes is one of the major therapeutic concerns globally. Moreover, Iran is among the countries with the highest incidence of diabetic patients. Furthermore, library-based studies by researchers have shown that thus far no study has been carried out to evaluate the relationship between Web-based diabetic personal health records (DPHR) and self-care indicators in Iran. OBJECTIVE: The objective of this study is to examine the effect of Web-based DPHR on self-care status of diabetic patients in an intervention group as compared with a control group...
October 21, 2016: JMIR Medical Informatics
Jake Luo, Christina Eldredge, Chi C Cho, Ron A Cisler
BACKGROUND: Understanding adverse event patterns in clinical studies across populations is important for patient safety and protection in clinical trials as well as for developing appropriate drug therapies, procedures, and treatment plans. OBJECTIVES: The objective of our study was to conduct a data-driven population-based analysis to estimate the incidence, diversity, and association patterns of adverse events by age of the clinical trials patients and participants...
October 17, 2016: JMIR Medical Informatics
Alvin Rajkomar, Joanne Wing Lan Yim, Kevin Grumbach, Ami Parekh
BACKGROUND: Characterizing patient complexity using granular electronic health record (EHR) data regularly available to health systems is necessary to optimize primary care processes at scale. OBJECTIVE: To characterize the utilization patterns of primary care patients and create weighted panel sizes for providers based on work required to care for patients with different patterns. METHODS: We used EHR data over a 2-year period from patients empaneled to primary care clinicians in a single academic health system, including their in-person encounter history and virtual encounters such as telephonic visits, electronic messaging, and care coordination with specialists...
October 14, 2016: JMIR Medical Informatics
Thomas Desautels, Jacob Calvert, Jana Hoffman, Melissa Jay, Yaniv Kerem, Lisa Shieh, David Shimabukuro, Uli Chettipally, Mitchell D Feldman, Chris Barton, David J Wales, Ritankar Das
BACKGROUND: Sepsis is one of the leading causes of mortality in hospitalized patients. Despite this fact, a reliable means of predicting sepsis onset remains elusive. Early and accurate sepsis onset predictions could allow more aggressive and targeted therapy while maintaining antimicrobial stewardship. Existing detection methods suffer from low performance and often require time-consuming laboratory test results. OBJECTIVE: To study and validate a sepsis prediction method, InSight, for the new Sepsis-3 definitions in retrospective data, make predictions using a minimal set of variables from within the electronic health record data, compare the performance of this approach with existing scoring systems, and investigate the effects of data sparsity on InSight performance...
September 30, 2016: JMIR Medical Informatics
Ye Zhang, Erin Willis, Michael J Paul, Noémie Elhadad, Byron C Wallace
BACKGROUND: Health science findings are primarily disseminated through manuscript publications. Information subsidies are used to communicate newsworthy findings to journalists in an effort to earn mass media coverage and further disseminate health science research to mass audiences. Journal editors and news journalists then select which news stories receive coverage and thus public attention. OBJECTIVE: This study aims to identify attributes of published health science articles that correlate with (1) journal editor issuance of press releases and (2) mainstream media coverage...
2016: JMIR Medical Informatics
Iee Choi, Jin Kyu Kim, Sun Jun Kim, Soo Chul Cho, Il Nyeo Kim
BACKGROUND: The treatment of neonatal and pediatric patients is limited to certain medical institutions depending on treatment difficulty. Effective patient transfers are necessary in situations where there are limited medical resources. In South Korea, the government has made a considerable effort to establish patient transfer systems using various means, such as websites, telephone, and so forth. However, in reality, the effort has not yet been effective. OBJECTIVE: In this study, we ran a patient transfer information system using a social app for effective patient transfer...
2016: JMIR Medical Informatics
Papis Wongchaisuwat, Diego Klabjan, Siddhartha Reddy Jonnalagadda
BACKGROUND: Community-based question answering (CQA) sites play an important role in addressing health information needs. However, a significant number of posted questions remain unanswered. Automatically answering the posted questions can provide a useful source of information for Web-based health communities. OBJECTIVE: In this study, we developed an algorithm to automatically answer health-related questions based on past questions and answers (QA). We also aimed to understand information embedded within Web-based health content that are good features in identifying valid answers...
2016: JMIR Medical Informatics
Shivapratap Gopakumar, Truyen Tran, Wei Luo, Dinh Phung, Svetha Venkatesh
OBJECTIVE: Our study investigates different models to forecast the total number of next-day discharges from an open ward having no real-time clinical data. METHODS: We compared 5 popular regression algorithms to model total next-day discharges: (1) autoregressive integrated moving average (ARIMA), (2) the autoregressive moving average with exogenous variables (ARMAX), (3) k-nearest neighbor regression, (4) random forest regression, and (5) support vector regression...
2016: JMIR Medical Informatics
Vladimir Robles-Bykbaev, Martín López-Nores, Jorge García-Duque, José J Pazos-Arias, Daysi Arévalo-Lucero
BACKGROUND: Speech and language pathologists (SLPs) deal with a wide spectrum of disorders, arising from many different conditions, that affect voice, speech, language, and swallowing capabilities in different ways. Therefore, the outcomes of Speech and Language Therapy (SLT) are highly dependent on the accurate, consistent, and complete design of personalized therapy plans. However, SLPs often have very limited time to work with their patients and to browse the large (and growing) catalogue of activities and specific exercises that can be put into therapy plans...
2016: JMIR Medical Informatics
Nathan Christopher Lea, Jacqueline Nicholls, Christine Dobbs, Nayha Sethi, James Cunningham, John Ainsworth, Martin Heaven, Trevor Peacock, Anthony Peacock, Kerina Jones, Graeme Laurie, Dipak Kalra
In parallel with the advances in big data-driven clinical research, the data safe haven concept has evolved over the last decade. It has led to the development of a framework to support the secure handling of health care information used for clinical research that balances compliance with legal and regulatory controls and ethical requirements while engaging with the public as a partner in its governance. We describe the evolution of 4 separately developed clinical research platforms into services throughout the United Kingdom-wide Farr Institute and their common deployment features in practice...
2016: JMIR Medical Informatics
Shahryar Eivazzadeh, Peter Anderberg, Tobias C Larsson, Samuel A Fricker, Johan Berglund
BACKGROUND: There are several frameworks that attempt to address the challenges of evaluation of health information systems by offering models, methods, and guidelines about what to evaluate, how to evaluate, and how to report the evaluation results. Model-based evaluation frameworks usually suggest universally applicable evaluation aspects but do not consider case-specific aspects. On the other hand, evaluation frameworks that are case specific, by eliciting user requirements, limit their output to the evaluation aspects suggested by the users in the early phases of system development...
2016: JMIR Medical Informatics
Ali Jassem Buabbas, Dawood Ameer Al-Shamali, Prem Sharma, Salwa Haidar, Hamza Al-Shawaf
BACKGROUND: Picture archiving and communication system (PACS) is a well-known imaging informatics application in health care organizations, specifically designed for the radiology department. Health care providers have exhibited willingness toward evaluating PACS in hospitals to ascertain the critical success and failure of the technology, considering that evaluation is a basic requirement. OBJECTIVE: This study aimed at evaluating the success of a PACS in a regional teaching hospital of Kuwait, from users' perspectives, using information systems success criteria...
2016: JMIR Medical Informatics
Clemens Scott Kruse, Krysta Kothman, Keshia Anerobi, Lillian Abanaka
BACKGROUND: The Health Information Technology for Economic and Clinical Health (HITECH) was a significant piece of legislation in America that served as a catalyst for the adoption of health information technology. Following implementation of the HITECH Act, Health Information Technology (HIT) experienced broad adoption of Electronic Health Records (EHR), despite skepticism exhibited by many providers for the transition to an electronic system. A thorough review of EHR adoption facilitator and barriers provides ongoing support for the continuation of EHR implementation across various health care structures, possibly leading to a reduction in associated economic expenditures...
2016: JMIR Medical Informatics
Danan Thilakanathan, Rafael A Calvo, Shiping Chen, Surya Nepal, Nick Glozier
BACKGROUND: Internet-based applications are providing new ways of promoting health and reducing the cost of care. Although data can be kept encrypted in servers, the user does not have the ability to decide whom the data are shared with. Technically this is linked to the problem of who owns the data encryption keys required to decrypt the data. Currently, cloud service providers, rather than users, have full rights to the key. In practical terms this makes the users lose full control over their data...
2016: JMIR Medical Informatics
Cecilia Garell, Petra Svedberg, Jens M Nygren
BACKGROUND: Digital health services empower people to track, manage, and improve their own health and quality of life while delivering a more personalized and precise health care, at a lower cost and with higher efficiency and availability. Essential for the use of digital health services is that the treatment of any personal data is compatible with the Patient Data Act, Personal Data Act, and other applicable privacy laws. OBJECTIVE: The aim of this study was to develop a framework for legal challenges to support designers in development and assessment of digital health services...
2016: JMIR Medical Informatics
Thomas McGinn
Pressures to contain health care costs, personalize patient care, use big data, and to enhance health care quality have highlighted the need for integration of evidence at the point of care. The application of evidence-based medicine (EBM) has great promise in the era of electronic health records (EHRs) and health technology. The most successful integration of evidence into EHRs has been complex decision tools that trigger at a critical point of the clinical visit and include patient specific recommendations...
2016: JMIR Medical Informatics
Patrick Michel Archambault, Pierre Beaupré, Laura Bégin, Audrey Dupuis, Mario Côté, France Légaré
BACKGROUND: Wikis have the potential to promote best practices in health systems by sharing order sets with a broad community of stakeholders. However, little is known about the impact of using a wiki on clinicians' intention to use wiki-based order sets. OBJECTIVE: The aims of this study were: (1) to describe the use of a wiki to create structured order sets for a single emergency department; (2) to evaluate whether the use of this wiki changed emergency physicians' future intention to use wiki-based order sets; and (3) to understand the impact of using the wiki on the behavioral determinants for using wiki-based order sets...
2016: JMIR Medical Informatics
Sari Palojoki, Tuuli Pajunen, Kaija Saranto, Lasse Lehtonen
BACKGROUND: The rapid expansion in the use of electronic health records (EHR) has increased the number of medical errors originating in health information systems (HIS). The sociotechnical approach helps in understanding risks in the development, implementation, and use of EHR and health information technology (HIT) while accounting for complex interactions of technology within the health care system. OBJECTIVE: This study addresses two important questions: (1) "which of the common EHR error types are associated with perceived high- and extreme-risk severity ratings among EHR users?", and (2) "which variables are associated with high- and extreme-risk severity ratings?" METHODS: This study was a quantitative, non-experimental, descriptive study of EHR users...
2016: JMIR Medical Informatics
Michael Mbagwu, Dustin D French, Manjot Gill, Christopher Mitchell, Kathryn Jackson, Abel Kho, Paul J Bryar
BACKGROUND: Visual acuity is the primary measure used in ophthalmology to determine how well a patient can see. Visual acuity for a single eye may be recorded in multiple ways for a single patient visit (eg, Snellen vs. Jäger units vs. font print size), and be recorded for either distance or near vision. Capturing the best documented visual acuity (BDVA) of each eye in an individual patient visit is an important step for making electronic ophthalmology clinical notes useful in research...
2016: JMIR Medical Informatics
Jose M Peeters, Johan W Krijgsman, Anne E Brabers, Judith D De Jong, Roland D Friele
BACKGROUND: Policy makers promote the use of eHealth to widen access to health care services and to improve the quality and safety of care. Nevertheless, the enthusiasm among policy makers for eHealth does not match its uptake and use. eHealth is defined in this study as "health services delivered or enhanced through the Internet and related information and communication technologies." OBJECTIVE: The objective of this study was to investigate (1) the current use of eHealth in the Netherlands by general practitioners (GPs) and health care users, (2) the future plans of GPs to provide eHealth and the willingness of health care users to use eHealth services, and (3) the perceived positive effects and barriers from the perspective of GPs and health care users...
2016: JMIR Medical Informatics
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