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Learning health system

Juan Jose Saldaña Barrios, Luis Mendoza, Edgardo Pitti, Miguel Vargas
In this work, the authors present two eHealth platforms that are examples of how health systems are migrating from client-server architecture to the web-based and ubiquitous paradigm. These two platforms were modeled, designed, developed and implemented with positive results. First, using ambient-assisted living and ubiquitous computing, the authors enhance how palliative care is being provided to the elderly patients and patients with terminal illness, making the work of doctors, nurses and other health actors easier...
October 21, 2016: Health Informatics Journal
Sanath Allampati, Kevin D Mullen
Hepatic Encephalopathy (HE) is a complex neuropsychiatric syndrome associated with decompensated liver disease. The spectrum of disease ranges from trivial abnormalities in complex decision making and prolonged reaction time to coma in its most severe form1. The very initial stages, recently termed covert Hepatic Encephalopathy (CHE), can only be diagnosed with the help of neuropsychiatric testing while the later and more severe forms, termed overt Hepatic Encephalopathy (OHE), can be diagnosed clinically. Severity of HE is graded based on West Haven Criteria and please refer to table 1 for more details2...
October 20, 2016: Minerva Gastroenterologica e Dietologica
Katherine R Amato
Research examining the gut microbiota is currently exploding, and results are providing new perspectives on human biology. Factors such as host diet and physiology influence the composition and function of the gut microbiota, which in turn affects human nutrition, health, and behavior via interactions with metabolism, the immune system, and the brain. These findings represent an exciting new twist on familiar topics, and as a result, gut microbiome research is likely to provide insight into unresolved biological mechanisms driving human health...
October 20, 2016: American Journal of Human Biology: the Official Journal of the Human Biology Council
Mareike Kroll, Revati Phalkey, Sayani Dutta, Sharvari Shukla, Carsten Butsch, Erach Bharucha, Frauke Kraas
BACKGROUND: Despite the rising impact of non-communicable diseases (NCDs) on public health in India, lack of quality data and routine surveillance hampers the planning process for NCD prevention and control. Current surveillance programs focus largely on communicable diseases and do not adequately include the private healthcare sector as a major source of care in cities. OBJECTIVE: The objective of the study was to conceptualize, implement, and evaluate a prototype for an urban NCD sentinel surveillance system among private healthcare practitioners providing primary care in Pune, India...
2016: Global Health Action
Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
Hans Lehrach
Every human is unique. We differ in our genomes, environment, behavior, disease history, and past and current medical treatment-a complex catalog of differences that often leads to variations in the way each of us responds to a particular therapy. We argue here that true personalization of drug therapies will rely on "virtual patient" models based on a detailed characterization of the individual patient by molecular, imaging, and sensor techniques. The models will be based, wherever possible, on the molecular mechanisms of disease processes and drug action but can also expand to hybrid models including statistics/machine learning/artificial intelligence-based elements trained on available data to address therapeutic areas or therapies for which insufficient information on mechanisms is available...
September 2016: Dialogues in Clinical Neuroscience
R J Kastner, C M Stone, P Steinmann, M Tanner, F Tediosi
In the last few years, the concepts of disease elimination and eradication have again gained consideration from the global health community, with Guinea worm disease (dracunculiasis) on track to become the first parasitic disease to be eradicated. Given the many complex and interlinking issues involved in committing to a disease eradication initiative, such commitments must be based on a solid assessment of a broad range of factors. In this chapter, we discuss the value and implications of undertaking a systematic and fact-based analysis of the overall situation prior to embarking on an elimination or eradication programme...
2016: Advances in Parasitology
Sarah Mahoney, Ruth M Sladek, Tim Neild
BACKGROUND: Although appropriate empathy in health professionals is essential, a loss of empathy can occur during medical education. The structure of clinical learning may be one factor that is implicated in a loss of empathy. This study examines student and doctor empathy, and possible associations between empathy and the structure of clinical learning. METHODS: There were three groups of participants: medical students (n = 281), who completed a longitudinal survey consisting of the Jefferson Scale of Empathy and an open question about empathy at the beginning and end of the 2013 academic year; private doctors (medical practitioners) in South Australia (n = 78) who completed a survey consisting of the Jefferson Scale of Empathy and an open question about empathy at the end of the students' academic year; and doctors (medical practitioners) from public teaching hospitals (n = 72) in southern Adelaide, South Australia who completed a survey consisting of the Jefferson Scale of Empathy at the end of the students' academic year ...
October 18, 2016: BMC Medical Education
Frances C Cunningham, Sue Ferguson-Hill, Veronica Matthews, Ross Bailie
BACKGROUND: Assessment of the quality of primary health care health delivery systems is a vital part of continuous quality improvement (CQI) processes. The Systems Assessment Tool (SAT) was designed to support Indigenous PHC services in assessing and improving their health care systems. It was based on the Assessment of Chronic Illness Care scale, and on practical experience with applying systems assessments in quality improvement in Indigenous primary health care. We describe the development and application of the SAT, report on a survey to assess the utility of the SAT and review the use of the SAT in other CQI research programs...
October 18, 2016: BMC Health Services Research
Christine Anne Ganzer
: A review of recent research and its relevance for nurses in all settings. ABSTRACT: The last two decades have seen increasing numbers of women entering all branches of the U.S. armed forces. Now that women in the military are no longer prohibited from holding direct combat positions, they are often exposed to traumatic events that place them at higher risk for mental health conditions. Nurses working within the Veterans Affairs (VA) system and those working in non-VA settings are likely to encounter female veterans...
October 13, 2016: American Journal of Nursing
Paul B Perrin, Lillian F Stevens, Megan Sutter, Anthony H Lequerica, Denise Krch, Stephanie A Kolakowsky-Hayner, Juan Carlos Arango-Lasprilla
OBJECTIVE: The research attempting to disentangle the directionality of relationships between mental health and functional outcomes after traumatic brain injury (TBI) is growing but has yielded equivocal findings or focused on isolated predictors or isolated outcomes. The purpose of the current study was to use cross-lagged panel and structural equation modeling (SEM) techniques to examine causality between comprehensive indices of mental health (depression, anxiety, and life satisfaction) and functional independence in a national sample of individuals with TBI over the first 2 years after injury...
October 13, 2016: American Journal of Physical Medicine & Rehabilitation
Carolina Luengo, Tatiana Paravic, Sandra Valenzuela
Objective To describe the causes of underreporting of occupational injuries and adverse events as identified in the international literature and by key informants in the area of health and risk prevention in Chile. Methods The study uses a qualitative descriptive approach. This includes a systematized literature review that follows the SALSA method (Search, Appraisal, Synthesis and Analysis) and is in line with the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). In addition, interviews were conducted with informants in the area of health and risk prevention in Chile...
February 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
Farzaneh Karimi-Alavijeh, Saeed Jalili, Masoumeh Sadeghi
BACKGROUND: Metabolic syndrome which underlies the increased prevalence of cardiovascular disease and Type 2 diabetes is considered as a group of metabolic abnormalities including central obesity, hypertriglyceridemia, glucose intolerance, hypertension, and dyslipidemia. Recently, artificial intelligence based health-care systems are highly regarded because of its success in diagnosis, prediction, and choice of treatment. This study employs machine learning technics for predict the metabolic syndrome...
May 2016: ARYA Atherosclerosis
Judit Lám, Gergő Merész, Gyula Bakacsi, Éva Belicza, Cecília Surján, Erika Takács
INTRODUCTION: The accreditation system for health care providers was developed in Hungary aiming to increase safety, efficiency, and efficacy of care and optimise its organisational operation. AIM: The aim of this study was to assess changes of organisational culture in pilot institutes of the accreditation program. METHOD: 7 volunteer pilot institutes using an internationally validated questionnaire were included. The impact study was performed in 2 rounds: the first before the introduction of the accreditation program, and the second a year later, when the standards were already known...
October 2016: Orvosi Hetilap
Andreas Holzinger
Machine learning (ML) is the fastest growing field in computer science, and health informatics is among the greatest challenges. The goal of ML is to develop algorithms which can learn and improve over time and can be used for predictions. Most ML researchers concentrate on automatic machine learning (aML), where great advances have been made, for example, in speech recognition, recommender systems, or autonomous vehicles. Automatic approaches greatly benefit from big data with many training sets. However, in the health domain, sometimes we are confronted with a small number of data sets or rare events, where aML-approaches suffer of insufficient training samples...
June 2016: Brain Informatics
Shahram Rafieifar, Hamed Pouraram, Abolghassem Djazayery, Fereydoun Siassi, Zahra Abdollahi, Ahmad Reza Dorosty, Mitra Abtahi, Hossein Kazemeini, Farshad Farzadfar
In Iran, as in most countries, cardiovascular diseases are the leading cause of death (highest mortality rate), but rank third in terms of disease burden. On the other hand, the relationship between high salt intake, hypertension, and cardiovascular disease has been proven. Food consumption pattern in Iran shows that consumption of salt, pickled foods and salty snacks is common. Regarding the World Health Organization (WHO) target for salt intake (about 5 g per day), the evidence indicates that Iranian people consume 2-3 times more than the recommended amount of salt...
October 2016: Archives of Iranian Medicine
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
Simon Kocbek, Lawrence Cavedon, David Martinez, Christopher Bain, Chris Mac Manus, Gholamreza Haffari, Ingrid Zukerman, Karin Verspoor
OBJECTIVE: Text and data mining play an important role in obtaining insights from Health and Hospital Information Systems. This paper presents a text mining system for detecting admissions marked as positive for several diseases: Lung Cancer, Breast Cancer, Colon Cancer, Secondary Malignant Neoplasm of Respiratory and Digestive Organs, Multiple Myeloma and Malignant Plasma Cell Neoplasms, Pneumonia, and Pulmonary Embolism. We specifically examine the effect of linking multiple data sources on text classification performance...
October 11, 2016: Journal of Biomedical Informatics
Yafit Maza, Efrat Shechter, Neta Pur Eizenberg, Efrat Gortler Segev, Moshe Y Flugelman
BACKGROUND: The physician manager role in the health care system is invaluable as they serve as role models and quality setters. The requirements from physician managers have become more demanding and the role less prestigious; yet burnout and its prevention in this group have received little attention. Physician leadership development programmes have generally dealt directly with skill and knowledge acquisition. The aim of this research was to evaluate an intensive workshop designed to modify attitudes and improve skills of physician-managers of community clinics, through focus on personal well-being and empowerment...
October 14, 2016: BMC Medical Education
John Y-K Lee, Jayesh P Thawani, John Pierce, Ryan Zeh, Maria Martinez-Lage, Michelle Chanin, Ollin Venegas, Sarah Nims, Kim Learned, Jane Keating, Sunil Singhal
BACKGROUND: Although real-time localization of gliomas has improved with intraoperative image guidance systems, these tools are limited by brain shift, surgical cavity deformation, and expense. OBJECTIVE: To propose a novel method to perform near-infrared (NIR) imaging during glioma resections based on preclinical and clinical investigations, in order to localize tumors and to potentially identify residual disease. METHODS: Fifteen patients were identified and administered a Food and Drug Administration-approved, NIR contrast agent (Second Window indocyanine green [ICG], 5 mg/kg) before surgical resection...
October 11, 2016: Neurosurgery
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