Day :
- Track 1: Healthcare Information Technologies and Communication
Track 4: Data Analytics, Artificial Intelligence, Big Data in Healthcare
Chair
Charles Boicey
Stony Brook Medicine, USA
Co-Chair
Murray Aitken
IMS Institute for Healthcare, USA
Session Introduction
Eric Maillet
HEC Montreal
Canada
Title: Examining the acceptance of an electronic patient record among nurses in acute care settings
Time : 14:25-14:50
Biography:
Eric Maillet has completed his PhD in Public health at the University of Montreal in the health services management doctoral program. He is currently a Postdoctoral research fellow at the Canada Research Chair in Information Technology in Health Care at HEC Montreal. He is a nurse and has been involved in the transition from the paper-based patient record to the electronic patient record since 2002 at the University of Montreal hospital center. He has been a clinical analyst for the implementation of a clinical information system and a project management advisor involved in various health information technology projects. His organizational mandates have led him to conduct research aiming at the computerization of clinical practices. His research interests focus at the acceptance of IT among healthcare professionals, the use of IT to support decision-making processes and the benefits of this important transition. He is also President of the Quebec Association of Nurses in systems and information technology (AQIISTI).
Abstract:
The transition from paper-based patient records to Electronic Patient Records (EPR) is a complex endeavor that may affect the quality and safety of care provided to patients. The acceptance of information technology (IT) by users is considered to be a critical success factor in realizing the benefits of EPR implementation. The aim of this presentation is to share the results of a multicenter cross-sectional study examining the explanatory factors of the actual use of an EPR by nurses and their satisfaction. A theoretical model based on the unified theory of acceptance and use of technology (UTAUT) was developed and tested on a sample of 616 nurses working in four acute care facilities. The study examined the relationships among eight different constructs, namely EPR compatibility, self-efficacy, performance expectancy, effort expectancy, social influence, facilitating conditions, the actual use of an EPR by nurses and their satisfaction. Thirteen research hypotheses (out of 20) were supported following structural equation modeling analysis. The results highlighted important mediation effects and revealed that performance expectancy, effort expectancy, facilitating conditions and compatibility of the EPR were strong determinants of the actual use of an EPR by nurses and their satisfaction. Although some results differ from those of previous studies, they show the applicability of the technology acceptance models and theories for nurses working in hospital centers. The study identified future research avenues and could help guide decision makers and change agents in determining the measures to implement in order to maximize the benefits of IT in healthcare.
Murray Aitken
IMS Institute for Healthcare
USA
Title: Closing the Healthcare Gap by Applying Predictive Analytics to Improve the Use of Medicines
Time : 14:50-15:15
Biography:
Murray Aitken is Executive Director of the IMS Institute for Healthcare Informatics. Established in 2011, the Institute focuses on the challenges facing the global healthcare industry, the role of medicines in patient care, and prospects for improving patient outcomes, managing costs and maximizing access globally through better use of healthcare information and technology. Prior to joining IMS in 2001, Murray was a partner at McKinsey & Company where he was based in the New Jersey, Seoul, and Los Angeles offices. Murray holds an M.B.A. degree with distinction from Harvard University, and a Master of Commerce degree from the University of Auckland in New Zealand.
Abstract:
The combination of expanded real-world data generation, technology platforms to access, link and aggregate the data, and advanced analytical methods, is bringing new opportunities to close the healthcare gap – reducing the difference between optimal care at reasonable cost and healthcare care as it is generally practiced. The value of predictive analytics is being recognized across the health system as a critical tool in the application of informatics, and can be utilized to improve the use of medicines. Specific areas of application include: identifying types of patients most likely to experience disease progression (prognostic models); detecting undiagnosed patients (diagnostic models); and patient-level responses to different treatment options (applied precision or personalized medicine models). Examples of such applications and impact brought to health systems will be presented. Further areas of opportunity to apply predictive analytics in high priority areas will require further development of data resources, analytic tools, and health systems aligned to applying predictive analytics as a critical input to decision-making.
Charles Boicey
Stony Brook Medicine
USA
Title: Healthcare does hadoop: An academic medical center’s five-year journey
Time : 15:15-15:40
Biography:
Charles Boicey is the enterprise analytics architect for Stony Brook Medicine, an academic research institution and medical center located on Long Island, N.Y. Charles is responsible for the development and implementation of enterprise analytics solutions and Stony Brook Medicine’s population management ecosystem. He has 22 years of experience in the healthcare field. His scope of expertise encompasses trauma, critical care nursing, designing technology-enabled processes, and ensuring the use of standardized data elements in clinical systems to meet clinical and research analytics requirements. His most recent work includes the development of Saritor, a healthcare centric “Big Data” ecosystem designed to advance clinical and research practice. He is a registered nurse, certified in nursing informatics, PMP, CPHIMS. He received his Master’s Degree in technology management from Stevens Institute of Technology. Charles is the vice president of the American Nursing Informatics Association and an active member of AMIA, HIMSS, IEEE, and PMI.
Abstract:
In 2010 the Clinical Informatics Team at the University of California, Irvine began a five year journey utilizing the technologies that power Face Book, LinkedIn and Twitter. This presentation will take the audience from the first use case utilizing a simple NoSQL environment through the evolutionary process that led to a “Big Data” ecosystem that ingests clinical, financial, medical device, patient self monitoring, social and geographic information system data to provide advanced analytics that serve the clinical, operations, financial and research needs of the organization. The session will focus on the lessons learned along the way.
Mirou Jaana
University of Ottawa
Canada
Title: The Telemonitoring Journey For Chronic Diseases - The Past Drives The Future
Time : 16:00-16:25
Biography:
Mirou Jaana completed her PhD in Health Management and Policy at the University of Iowa, and her post-doctoral fellowship in Health Information Technology at HEC Montreal. She conducted extensive research on IT assessment in health care including the implementation of information systems and electronic medical records, risks and mitigation strategies in clinical IT projects, and IT strategic planning and management issues in hospitals. She also developed several systematic reviews on the use and impacts of telemonitoring for chronic diseases. Her work appeared in leading journals, including JAMIA, American Journal of Managed Care, IJMI and JMIR. Her publications made significant contributions to research on telemonitoring, as indicated by the high number of citations for these articles. Dr. Jaana is currently working on a project investigating the factors that affect the adoption and use of telemonitoring technology among elderly.
Abstract:
Telemonitoring represents a promising patient management approach, which has been extensively studied in the literature over the last two decades. It leverages technology for the close follow-up and management of patients through timely transmission of clinical and physiological data that enables prompt medical interventions when needed, prior to worsening in a patient’s condition. Its application in relation to chronic diseases (e.g., diabetes, heart failure, respiratory conditions, and hypertension) has been researched and advocated in different countries. The aging of populations around the world, the increasing burden of chronic diseases, and the resulting skewed heath care expenditures have raised concerns over the capacity of existing health care systems to deal with these challenges. Telemonitoring of patients with chronic diseases is perceived as a powerful and viable intervention for managing patients with these conditions, which is capable of addressing existing resource challenges, as well as concerns observed with the delivery of chronic care. Different modalities, arrangements / settings, and technologies related to telemonitoring have evolved in the literature, and the heterogeneity of the studies investigating this approach has been documented. Despite the abundance of articles, beginning with empirical studies and progressing into reviews, most of the reported evidence emphasized on specific outcomes measures to accentuate its relevance and viability as a patient management approach, and highlighted methodological weaknesses and discrepancies in the conducted evaluations to be addressed in this track of research. Potential benefits associated with telemonitoring remain to be exploited, which should guide future research agendas and investments in this field.
Fatemeh Vafaee
The University of Sydney Australia
Title: Analysis of long non-coding RNAs expression profiles in ovarian cancer-associated fibroblasts
Time : 16:25-16:50
Biography:
Fatemeh Vafaee received her Bachelor of Science in Computer Engineering from Sharif University of Technology, Iran, where she learned the foundations of computer science on different topics, including the theory of computation, algorithms and data structures, artificial intelligence and information retrieval. She was then admitted, as a direct PhD student, to the computer science program at the University of Illinois at Chicago. As a researcher in the Artificial Intelligence Laboratory, she had the opportunity to extend and enrich her knowledge in the context of Artificial Intelligence. She got involved in various research projects, and developed and applied different AI techniques, particularly in the domains of optimization, machine learning, data mining, and pattern recognition. She also collaborated with the university’s Computational Biology Laboratory, where she extended her research to biological applications such as protein-protein interaction network comparison, sequence alignment, phylogeny reconstruction, motif discovery, and the study of models of DNA evolution. After receiving her PhD degree, Fatemeh joined the University of Toronto, University Health Network and Ontario Cancer Institute, one of the largest medical research centres in Canada and worldwide. During her Postdoctoral research, she focused her research on integrative computational biology and cancer biomarker identification. She collaborated on several projects, and expanded her biological knowledge to effectively utilize and analyse different genomic, proteomic, molecular chemicals and interaction databasesto get new insights into disease diagnosis, therapy, and prevention strategies. She then joined the University of Sydney, Charles Perkins Centre as a research fellow in computational modelling and systems biology.
Abstract:
Ovarian cancer is the most lethal gynaecological malignancy in women. Expression profiling of the high-grade serous subtype has revealed that patients exhibiting a “stromal expression signature” demonstrate the poorest prognosis. However, genetic aberrations in ovarian cancer-associated-fibroblasts (CAFs) are extremely rare, raising the possibility that alternative mechanisms that regulate gene expression, such as long non-coding RNAs (lncRNAs), are present in CAFs. LncRNAs are polyadenylated RNA transcripts that do not encode for proteins, but have shown to be promising markers in tumourigenesis. Therefore, we aim to identify lncRNAs biomarkers expressed in ovarian CAFs. CAFs were laser-capture micro-dissected from 51 advanced-stage ovarian tumours and 10 normal ovaries removed from women for non-cancer reasons. RNA was extracted from the micro-dissected samples and expression analysed using Affymetrix U133-Plus-2.0 Arrays. 2,448 probes previously identified as lncRNAs were used in this analysis. LncRNAs differentially expressed in cancer-versus-normal samples were calculated by empirical Bayes shrinkage of the standard errors and moderated t-statistics were used to assess significance. P-values were corrected using FDR method. 54 lncRNAs were identified as differentially expressed in CAFs based on a significance cut-off of fold-change > 2 and adjusted-p-value < 0.05. These include lncRNAs previously implicated in ovarian cancer (e.g., XIST, H19, and p53-regulated lncRNA TUG1), and several lncRNAs known to play roles in other cancers (e.g., NEAT1, GAS5 and CASC2). Gene set enrichment analysis was then used to identify biological processes enriched by protein-coding genes significantly correlated with a set of differentially expressed lncRNAs. Functional analyses of correlated mRNAs revealed possibility of lncRNA participation in carcinogenesis by regulating protein-coding genes involved in cancer-related biological processes.
Daisuke Tominaga
National Institute of Advanced Industrial Science and Technology, Japan
Title: Multi-omics estimation on comprehensive measurement of gene expression levels to identify stress response pathways
Time : 16:50-17:15
Biography:
Daisuke Tominaga has completed his PhD at the age of 30 years from Kyushu Institute of Technology. He is the senior staff scientist at the Biotechnology Research Institute for Drug Discovery of the National Institute of Advanced Industrial Science and Technology (AIST) of Japan, and is working on developing computational algorithms for statistical analysis on biological data, time series analysis and network dynamics.
Abstract:
Living cells respond to environmental stresses. Specific genes are expressed and pathways are activated in the responses. While changes in gene expression levels are today measured comprehensively with reasonable cost, measuring activities of each pathway is still difficult even many cutting-edge observation techniques such as one molecule observation methods have been realized. Therefore pathway activities are estimated from gene expression levels. By identifying the mechanisms of stress responses, introducing heat shock response mechanisms of some micro organisms to valuable and weak strain in heat, or using mouse as a model of human disease may be able.We tried to identify the activated pathway as the response to the stress from comprehensive gene expression level measurement by DNA microarrays. We measured sample in two conditions, under the stress and no stress, five sample in each, then the gene enrichment analysis was done on annotations of measured genes to calculated score values for each pathway appears in the annotation. First, we selected the median values of the five measurements as the expression values for each gene. Change values are calculated as logarithms of ratios of expression values of stressed samples to no stress samples for each gene. Top five percents of highly changing genes are selected as specifically changing genes. We calculated statistically p-values for each pathway that is annotated to all specifically changing genes by Fisher’s exact test. Then, pathways with low p-values are listed as those responding to the stress.
Said Alghenaimi
Rustaq Nursing Institute
Oman
Title: The role of Electronic health records in structuring nursing handoff communication and maintaining situation awareness
Time : 17:15-17:40
Biography:
Said Alghenaimi attained his PhD in Information Science and Learning Technologies from the University of Missouri, USA in the year 2012. He started his Profession as a staff nurse in 1998. Over the past 17 years, he assumed many roles and responsibilities. He worked as a Usability Expert at the Information Experience Laboratory at the University of Missouri. This has led him to do more researches in Human-Computer Interaction, Human Information Behaviors, and usability evaluations of websites and mobile applications. Currently, he is the Dean of Rustaq Nursing Institute, Sultanate of Oman.
Abstract:
In healthcare institutions, work must continue 24 hours a day, 7 days a week. A team of nurses is needed to provide around-the-clock patient care, and this process requires transfer of patient care responsibilities, a process known as a “handoff.” The study was conducted in the Sultanate of Oman, exploring the role of electronic health records in structuring handoff communication and maintaining situation awareness among nurses during handoff. Several theoretical frameworks and models were used to guide this study, which aims to assess the satisfaction of nurses regarding the usefulness and ease of use of the electronic health records for nurses during handoff, to explore the contents and the context of nursing handoff, and to explore the artifacts that the nurses use to in order to ensure the continuity of care and the delivery of quality handoff reports. A mixed-method, quantitative and qualitative, approach was used to study the role of the electronic health records in structuring handoff communication and to explore handoff practices in Oman. The findings of this study demonstrated that the nurses had positive perceptions about the usefulness and ease of use of electronic health records for structuring handoff communication and promoting effective and efficient transition of patient care during handoff. The study also revealed that nurses use a variety of artifacts to document, communicate, and coordinate patients’ care reasonability during handoff. The electronic health records, Al-Shifa, were found to be the primary artifact that the nurses used to facilitate electronic documentation of patient care and to promote effective and accurate communication among the nurses during the transition of care. The use of electronic health records during handoff was reported to increase the accessibility to patients’ medical records and ensure both the continuity of care and the delivery of quality handoff reports. Despite the integration of electronic health records into the handoff reports, all the observed nurses (N=97) and the surveyed nurses (N=157) used a piece of paper to summarize the key information they received during the handoff report. Throughout the shift, this piece of paper served as a non-digital artifact that provided“quick-reference” for the nurses as well as a “to-do list”.
- Track 5: Health care Communication Networks and Environment
Track 8: Clinical and Public Health Informatics
Chair
Eduardo J Simoes
University of Missouri School of Medicine, USA
Co-Chair
Vivian Vimarlund
Jönköping University, Sweden
Session Introduction
Julie M. Kapp
University of Missouri School of Medicine
USA
Title: A Hierarchical Framework for Population Health Surveillance: A Dashboard Approach
Time : 11:35-12:00
Biography:
Julie M. Kapp, MPH, PhD is an Associate Professor with a background in public health and evaluation. Her faculty appointments have included notable roles, such as: the Executive Director of the Health and Behavioral Risk Research Center, Margaret Proctor Mulligan Faculty Scholar, and Executive Director of the Partnership for Evaluation, Assessment, and Research. She has served as an NIH grant reviewer, an Associate Editor for BMC Cancer, and a journal reviewer for such notable titles as Cancer, International Journal of Cancer, and The Lancet. She recently completed a year-long Malcolm Baldrige Executive Fellows Program focused on aligning and integrating systems.
Abstract:
The Institute of Medicine (IOM) recently recommended a set of core metrics in an effort to improve data harmonization for the U.S. population health system and lay the foundation to measure performance improvement. Even with a set of common metrics, it is challenging to evaluate the effectiveness of population health initiatives dues to the many community-based organizations, and their complex interactions. The term ‘complex adaptive systems’ (CAS) acknowledges that health programs and activities are part of larger networks of stakeholders with histories and evolving dynamics. Systems engineering considers how components within the larger CAS structure operate and interact over the life cycle of the system; and how to optimize the design, implementation, and evaluation of that system. We propose a hierarchical systems framework, using a dashboard approach, in order to monitor U.S. population health progress with five system components: context, components, connections, infrastructure, and scale (Eoyang and Berkas, 1998). The framework aligns and integrates metrics across local (organization, hospital, city), regional, state, and national levels for data visualization and decision-making. Each metric may be computed in various ways to allow for noise, depending on the available data, and its result propagated and integrated at the higher level. Our pilot uses an obesity example. We compute obesity levels from various data sources at the local, regional (Boone County), and state levels in Missouri, USA. After data harmonization, metrics dynamics measures (decrease, rate of decrease, etc.) can be used to evaluate the impact of health programs implemented in Boone County.
Eduardo J Simoes
University of Missouri School of Medicine
USA
Title: Web-based applications for prioritizing health: A case study of 27 capital cities in Brazil 2006-2012
Time : 12:00-12:25
Biography:
Eduardo J Simoes, MD, is Chair and Alumni Distinguished Professor of the Department of Health Management and Informatics-University of Missouri School of Medicine (2011-current). He has a medical degree from Faculdade de Medicina, Universidade de Pernambuco in Brazil (1981), diploma and a Master of Sciences degree from University of London School of Hygiene Tropical Medicine (1987) and Master of Public Health degree from Emory University School of Public Health (1991). He is a fellow of the American College of Epidemiology. He has published 106 articles, eight book chapters and 18 reports, made 142 conference presentations, and reviewed/edited for 12 journals.
Abstract:
Introduction: Because public health funds are limited, programs need to be prioritized. We developed two indices to prioritize public health based on chronic disease risk factors (CDRF-PHI) and diseases (DZ-PHI). Methods: We used surveillance data from 27 capital cities in Brazil (2000-2012) about 12 risk factors and 32 diseases for CDRF-PHI and 51 diseases for DZ-PHI. We re-scaled and standardized indicators for risk factors and disease groups to create dimensionless scores. CDRF-PHI and DZ-PHI rank priorities using the sum of the rank of scores, the product or sum of scores across criteria: magnitude, severity, urgency, disparity, intervention effectiveness, intervention cost, and community preference. The current offline version of PHIs limits their use by public health practitioners. We developed a web application (PHP; MySQL-database) to help users upload surveillance data and calculate PHIs at any geographical level. We integrated the statistical R software within the application to conduct analysis. Results: For the combined 27 capital cities of Brazil, the six priority risk factors were physical inactivity, hypertension, hypercholesterolemia, smoking, heavy drinking and no hypertension screened in past 2 years; the 15 priority diseases were heart disease, pneumonia/influenza, other infectious diseases, assault/homicide, stroke/other cerebrovascular disease, diabetes, other diseases/disorders, health infant issues (<1 year), alcohol/related disorders, other mental diseases, HIV/AIDS, motor-vehicle accident, falls, zoonosis and colorectal cancer. Conclusions: Identified public health priorities varied across the 27 Brazilian capital cities. PHIs summarize and harmonize data from multiple indicators, health conditions and factors.
Dipankar Sengupta
Vrije Universiteit Brussel (VUB)
Belgium
Title: CliniPhenome: Clinical and phenotypic annotation database
Time : 12:25-12:50
Biography:
Dipankar Sengupta has completed his PhD in Bioinformatics from, Jaypee University of Information Technology, India. Currently, he is working as a Post doctoral researcher at COMO-Artificial Intelligence Lab, Vrije Universiteit Brussels, Belgium in BRiDGEIris project. Prior to this, he was working as Assistant Professor in Dept. of Bioinformatics & Biotechnology, Jaypee University of Information Technology, India. He aspires to unveil the intricacies of problem statements in life science and posses a passion to solve them with the aid of bioinformatics skills. His research interest broadly lies in the domain of Data mining, Database design & development, Algorithm design, Web interface development and Exploratory analysis. His primary research is focused on translational computing of clinical data with a considerable focus on temporal mining and auguring state of a disease for a patient. Currently, he is working on designing a Clinical-Phenomic Database and on development of machine learning approaches to connive comorbid patterns among the genomic variants with their associated clinical data.
Abstract:
As a part of the BRiDGEIris project, a clinical database CliniPhenome, has been developed that supports clinical and phenotypic annotation for patients. The project aims to develop a big data platform that can be used for sharing genomic and clinical data and support discovery studies in clinical genomics. A part of this goal was attained by the proposal of a generalized clinical schema design along with a merged ontology schema that provides cross-referencing possibilities. Also, introduction of the controlled vocabulary and data structure answers for the prevalent problem of plain text storage in the existing clinical databases, which causes impediment during data analysis. CliniPhenome not only supports the collection of patient data but also phenotypic and clinical annotation. Phenotypic annotation is supported by autogenously designed ontology that supports for Human Phenotype Ontology (HPO), Online Mendelian Inheritance in Man (OMIM) and Orphanet. Clinical annotation is currently supported by LOINC and SNOMED, with eventual assimilation of ICD-10 into it. It is a PHP based application with an easily operated interface that runs on a web browser and is facilitated by a MySQL database. A generalized schema design has been proposed, that ensures improved empathy among clinicians and researchers. Besides, it also features data migration utility that supports exchange of de-identified data in XML or JSON structure among the collaborators. In conclusion, CliniPhenome features streamlining of clinical workflow, efficient data entry and retrieval, improved diagnosis, cross-referencing of patient phenotype with clinical annotation, and sharing of de-identified patient data for research purposes.
Patrizia Colangeli
Istituto Zooprofilattico Experimental and Molise
Italy
Title: The integration of a laboratory information management system within a national livestock identification and traceability system in African countries
Time : 13:35-14:00
Biography:
Patrizia Colangeli has a degree in Engineering from the University “La Sapienza” of Rome, Italy. She worked at a private company in the applied mathematics and economy sector in Rome and after in a Bank in Teramo. Since 1991, she has worked at the Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise (IZSAM) where she is the Head of “Information systems development and management” unit. She managed the analysis and implementation of many information systems at enterprise, regional, national and sovra-national level among which: The Animal Health National Information System (i.e. Brucellosis, Bluetongue, West Nile Disease), Laboratory Information Management System, Administrative and Staff information management system, the Datawarehouse enterprise, National information system for the notification of animal diseases; Zoonoses National System, Web-based application for the international surveillance of bluetongue in the European Union, OIE Bluetongue Reference Laboratories network, and the SILAB for Africa: A LIMS for African Labs currently used in Namibia, Botswana, Zimbabwe, Zambia, and Tanzania.
Abstract:
The control of animal diseases relies on rapid, accurate and reliable diagnoses, allowing early detection and response to disease outbreaks. Reduction in diseases, in particular zoonosis and greater safety of food have a direct effect on human health. In addition, the efficiency of a laboratory, and in particular accreditation according to ISO/IEC 17025 standards, is a pre-requisite for countries to access international trade.The LIMS called “SILAB for Africa” (SILABFA) is a web application developed by the Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise (IZSAM), it is in routine use in five different National Veterinary Laboratories in Namibia, Botswana, Zimbabwe, Zambia and Tanzania. A LIMS system is an important element of the chain of the traceability system such as the Livestock Identification and Traceability System (LITS) (e.g. LITS in Botswana, NAMLITS in Namibia, TANLITS in Tanzania). The inter-linkage and inter-operability between SILABFA and a LITS system can therefore greatly improve the quality of the entire cycle of livestock production from the field to the laboratory, up to the export process. Such inter-operability can allow to insert data only once in one system and make data automatically available to other systems in use which enables rapid and fluid data transfer. It can then increase the effectiveness and efficiency of services involved in this whole chain, enhancing the exchange of information, promoting a better communication among operators, even across borders and allows a systematic ongoing collection of animal health information available and analyzed by the Epidemiological Unit.
Ingrid Hegger
National Institute for Public Health and the Environment
Netherlands
Title: Characterization of apps and other e-tools for medication use: Insights into possible benefits and risks
Time : 14:00-14:25
Biography:
I Hegger completed her PharmD at Utrecht University of Utrecht and is a Senior Researcher at the National Institute for Public Health and the Environment, The Netherlands. She is an expert on the regulation of medicinal products, with special interest in biologicals. Currently, her focus is on “close-to-policy” projects in the field of medical products, pharmaceutical care and health policy. She is project leader of project ‘e-Medication’ on the influence of internet on medicines use and involved in projects on the EU regulatory system for medicinal products and clinical trials. Furthermore, she is working on her PhD in a strategic research project on the utilization of knowledge within public health policy and healthcare supervision.
Abstract:
Little is still known regarding the use, possible effectiveness and risks of the enormous number of available health-related applications (apps). Many people use medicines and might benefit from tools that aid in the use of medicine, but could also have risks. Our aim was to gain more insight into the characteristics, possible risks and possible benefits of health apps and e-tools related to medication use.We investigateda selection of apps and other e-tools (n=116), including their characteristics. We found that a small subset of tools might involve relatively high risks (medical devices - class II and used by patients without involvement of health care professionals). On the other hand, a large majority of the tools (>80%) were assessed as relatively low risk tools (‘non-medical device’). However, the availability of these e-tools is enormous and poor functionality of these e-tools might have negative health effects for users. Since regulation of all the available health apps is impossible due to high numbers and constant changes, it is important for the general public to receive proper education concerning the possible risks associated with using apps and e-tools.
Maureen Lucy Schafer
George Mason University
USA
Title: Integrating Healthcare Informatics into Academia through application of the Systems Life Cycle model
Time : 14:25-14:50
Biography:
Maureen Lucy Schafer received her Ph.D in Health Care Systems and Informatics from the University of Arizona. An enterprise level clinical informaticist, Family Nurse Practitioner and military veteran, Dr. Schafer possesses a comprehensive background in advanced clinical care, health care systems, teaching and expert application of the Systems Life Cycle model. This training and accountability is derived from 25 years of experience in the United States Army, consulting, teaching and informatics work within and across academia and multiple health care organizations. Presently, she is a professor leading the growth of a robust Nursing informatics program at George Mason University within the College of Health & Human Services.
Abstract:
Routine reliance upon Information Technology (IT) and Informatics is now an essential standard for safe professional clinical practice. A challenge educators face is to incorporate the tenets of Informatics into the curriculum. To be prepared, the student clinician must not only understand the system but also the relationships between the technology, the information, and the processes and its impact on effective clinical practice. Over the past two years a 15 week graduate course was transformed to focus learning through a relevant team project from a health care system problem in an actual healthcare organization. The project stair-steps through the Systems Life Cycle model and is applied to healthcare systems and informatics in a clinical setting. Outcomes demonstrate that students successfully analyze the impact of data, information, and knowledge within the context of a model and learn to critically evaluate how information resources, if properly deployed, can address the challenges defined in an IT health care system problem. The real time System Life Cycle projects culminate in an executive summary with measured outcomes and is presented to the selected health care organization where the system issue was defined.
Daniele De Falco Alfano
University of Ferrara, Italy
Title: Texture Analysis of clear cell renal cell carcinoma
Time : 14:50-15:15
Biography:
Daniele De Falco Alfano began his experience in experimental radiology with the medical degree received in October 2009 at the University of Ferrara (Italy). In June 2011, he started the residency in radiology at the same University and over the last 3 years he has focused his scientific interests in Cancer Imaging and Texture Analysis. He has published more than 12 papers in reputed journals and has been serving as an Reviewer for European Radiology, La Radiologia Medica Journal, Tumori Journal and Journal of Radiology Case Report. He is the Member of: European Congress of Radiology (ECR), Radiological Society of North (RSNA), Italian Society of Radiology (SIRM).
Abstract:
Purpose: The main goal of this retrospective study in blind, was to evaluate the accuracy of Mean value of Positive Pixels (MPP) texture parameter in tomodensitometric evaluation of renal cell carcinoma. Materials & Methods: IRB approval was obtained for the study. All patients who underwent a surgical nephrectomy (radical or partial) between January and December of 2013 has been identified. The study sample consisted of 33 men and 16 women between the age of 37 and 91 years. The TCTA study was conducted using the commercial software Image J, National Institutes of Health, USA. Result: A statistically significant correlation between MPP values (rs=0.66; p<0.001) with Histologic Grading (Gold Standard) was documented. The average values of MPP were significantly lower in the non-tumor lesions (MPP 92.63±3.81) compared to well-differentiated lesions G1 (MPP=112.35±4.03), moderately differentiated lesions G2 (MPP = 142.41±13.83; ) and G3 (PP = 147.21±10.74) and to poorly differentiated lesions G4 (MPP =177.89±6.57). The intra-observer and interobserver accordande was excellent (respectively a=0.94 and 0.96). Conclusion: The CT Texture Analysis is a valid aid for the characterization of tumor lesions allowing a clear distinction of well differentiated carcinomas (G1), moderately differentiated (G2 and G3) and poorly differentiated (G4). The evaluation of MPP texture parameter represent an accurate and reproducible approach for tomodensitometric characterization of renal cell carcinomas.
Véronique Dubé
Université de Montréal
Canada
Title: Learning to become a family care-giver of a person recently diagnosed from Alzheimer’s disease: How a web-based intervention can help?
Time : 15:35-16:00
Biography:
Véronique Dubé was a scholarship recipient of the Hospital Foundation of the University of Montreal (CHUM) and a Doctoral fellowship from the accompanying National Researcher award from the FRSQ assigned. Francine Ducharme PhD, she is also a fellow of the Faculty of Nursing at the University of Montreal (purse Evelyn Adam-2007 scholarship Virginia Allaire 2010), the Interuniversity Research Group Nursing Intervention Quebec (GRISIIQ; 2007-2008 and 2008-2009) and the Ministry of Education, Leisure and Sport (MELS) in 2009-2010 and 2011-2012. She also earned a scholarship to support the dissemination of research results of the Quebec Network for Research on Aging (RQRV) and recently she received the fellowship of Health Research Institutes to Canada.
Abstract:
It has been known for several years that the support and care of a person diagnosed from Alzheimer’s disease are provided by family members, and often to the detriment of their own health and quality of life. The multiple responsibilities of care-givers are often perceived as stressors that require a repertoire of coping mechanisms. Over the last few years, a team from the Desjardins research chair in nursing care for seniors and their families has developed and evaluated a number of psychoeducational interventions striving to support family caregivers. Recently, the team explored an innovative approach by using information and communication technologies. A psycho-educational web-based intervention program promoting the adaptation to the care-givers’ role of a person recently diagnosed with Alzheimer's disease was designed. A pilot study assessed its implementation process and evaluated its effects on selected indicators of caregivers’ adaptation. The intervention program was offered to 20 care-givers who received an online training and tutoring by a healthcare professional over a period of seven weeks. Focused readings and exercises allowed family care-givers to acquire new supportive strategies based on their daily experiences as a care-giver. A brief description of the web sessions of this educational program will be presented as well as examples of the use of the web-based learning platform by family care-givers. This intervention approach, complementary to other types of interventions has several advantages, particularly for care-givers who are geographically distant from healthcare services and who have limited access to support groups or individual face to face interventions.
Harsha K Rajasimha
Strand Life Sciences, USA
Title: New generation health care delivery through smart labs capable of offering next-generation sequencing based multi-gene panels
Time : 16:00-16:25
Biography:
Harsha K Rajasimha is Vice President of Global Business Development at Strand Genomics Inc., a new generation healthcare company and a global leader in personalized medicine. He is affiliate faculty in systems biology at the George Mason University and is a co-founder of the Organization for Rare Diseases India. His career has spanned academia, non-profits, Government, Information Technology, and Biotechnology in highly interdisciplinary multinational environments. He is passionate about applying genomics to personalizing healthcare and increasing global food production. He holds a masters degree in computer science and doctoral degree in Genetics, Bioinformatics and Computational Biology from Virginia Tech, USA.
Abstract:
In the past decade, we have overcome the grand challenge of being able to sequence a human genome for $1000 within a week. This is already having tremendous implications on how health care is delivered to patients. For cancer care, it is critical to accurately classify the tumor at the molecular level and enable the oncologists to make the right clinical decisions through data integration, curation, mining and reporting by applying next-generation sequencing (NGS) technologies. The opportunity is real and applies to almost all human diseases – rare and common. It still takes about 7 years on an average to diagnose a rare disease in USA and the European Union. This is because of the large number of rare diseases (>7000), lack of genetic education among physicians and the lack of awareness among the general public. About 80% of these rare diseases are estimated to be caused by inherited mutations and many of them are treatable. There is a huge opportunity to improve our speed and accuracy of diagnosing rare diseases world-wide. Using real-world examples and use cases, I will present how recent advances in clinical genomics are enabling a new generation of diagnostic tests for clinical decision support. A comprehensive clinical genomics workflow and the Strand Smart Lab model for delivering personalized medicine tests at community hospitals will be discussed.
Sandra Milena Agudelo-Londono
Pontificia Universidad Javeriana
Colombia
Title: CODIFICO: Teaching game for health coding
Time : 16:25-16:50
Biography:
Sandra Milena Agudelo-Londono is a Health information system Manager and has a Master in Epidemiology from Universidad de Antioquia in Colombia. She is Professor of Health Information Systems and Managerial Epidemiology in Pontificia Universidad Javeriana, Bogotá. She has published several papers in reputed journals and has been serving as the Editorial Board Member of Health Management and Policy Journal in her country.
Abstract:
Directing health systems requires quality information. The basis for the management of health services are medical diagnostics. Proper and accurate coding is essential for the Colombian health system. In Colombia, whether the hospital has electronic or manual medical records, health professionals encode diagnoses without receiving training on how to do it, but by learning empirically and reproducing information biases where they learn. For this, we are working on the design and implementation of a mobile tool (app) called (CODIFICO) to develop skills in diagnoses coding by playful strategies (gamification). So students of health careers learn to codify diagnoses of diseases not by memory but by associations and pathological themed trees. So that, regardless of the type of medical records system, health professionals can, through learning and fun way, encode properly the diagnostics and this reflects in: Better use of time dedicated to care, better health risk management, and at the macro system, accurate diagnosis needed to provide efective health services. It has been identified that implementation of teaching strategies through technological tools such as m-health enhance learning; this is the technical assumption of this project. We will use a methodology before-after evaluation of the quality metrics in the register of medical diagnosis and analysis of usability of the app. It is expected that by their playful nature, the app can be offered free regardless of language, in the smartphones online stores.
Hayat Mushcab
University of Ulster
Northern Ireland
Title: The journey of a researcher in a diabetes clinic: Expectations vs. reality
Time : 16:50-17:15
Biography:
Hayat Mushcab has completed her BSc in Health Information Management & Technology at the age of 22 years from King Faisal University. She continued her education and achieved her MSc in Computing and Intelligent Systems at the age of 24 years from the University of Ulster. She is currently in her final year of her PhD studies in the field of Telehealth/Telemonitoring and Connected Health at the University of Ulster in the Faculty of Life and Health Sciences. She has 2 publications in International Journals.
Abstract:
In theory, conducting robust clinical research is a matter of developing a strong proposal and following it through. However, the reality of conducting a research is a complicated process involving many obstacles that challenge the researcher from start to finish. In this paper we aim to reflect on our experience conducting our study and describe the challenges we came across throughout the study and how we were able to manage them. We provided a brief overview of our study’s design and location and pragmatically discuss the challenges as they arose.
- Track 9: Patient Engagement Strategies and Experiences
Track 12: Interactions with Health Information Technologies
Chair
Gunnar O Klein
Örebro University School of Business, Sweden
Co-Chair
Placide Poba-Nzaou
University of Quebec in Montreal, Canada
Session Introduction
C Peter Waegemann
Waegemann Associates
USA
Title: mHealth is enabling ecare
Time : 10:00-10:25
Biography:
C Peter Waegemann was CEO of Medical Records Institute for over 25 years. He was also Executive Director of Center for Cell-Phone Applications in HealthCare (C-PAHC) and President of mHealth Initiative. Since the 1980s, he has been a visionary and promoter of electronic medical record systems (EMRs). He is internationally known as one of the top experts in healthcare informatics, has published both in the US and in Germany, and is a sought-after speaker on EHRs, eHealth, and mHealth. He has special expertise in electronic patient record systems, standards, networking, telemedicine, and the creation of the national information infrastructure. Waegemann has testified to US Congressional committees. In 2007, he was cited as one of 20 outstanding people who make healthcare better (HealthLeaders). He is the Author of hundreds of publications, including Editor of 18 proceedings books; 100+ published articles and the Past Editor-in-Chief, "Health IT Advisory Report”.
Abstract:
mHealth differs from telemedicine in that it is multi-lateral. In contrast, telemedicine depicts bilateral communication between two partners, in many cases between two providers. The definition of mHealth should not stop at the use of mobile devices, such as smart phones, tablets, watches, or glasses. mHealth has seven distinct elements: (1) Internet resources for patients, (2) Internet access for physicians and other professionals, (3) new devices and their apps representing new tools, (4) new communication patterns and systems, (5) new research, financial, and administrative solutions, (6) enabling data collection in homes and in other places through sensing, tracking, and other therapeutic methods, (7) enabling documentation systems at the point of care and/or away from the office. eCare involves both information-driven care processes and artificial intelligence (AI) in the diagnostic and care process. mHealth enables medical Big Data as well as the Internet of medical Things. mHealth enables the use of non-medical data such as environmental, behavioral, or nutrition-related information to provide further insights into a patient’s health in order to achieve Care, which involves personal care, communication-based care, and AI-based decision making. The implementation of mHealth varies in different regions. The status of implemented features of the Digital Society, as well as legal and professional issues, determines a country’s readiness to take advantage of the benefits mHealth provides.
Ingrid Hegger
National Institute for Public Health and the Environment (RIVM)
Netherlands
Title: Empowerment of patients in online discussions about medicine use
Time : 10:25-10:50
Biography:
I Hegger completed her PharmD at Utrecht University of Utrecht and is a Senior Researcher at the National Institute for Public Health and the Environment, The Netherlands. She is an expert on the regulation of medicinal products, with special interest in biologicals. Currently, her focus is on “close-to-policy” projects in the field of medical products, pharmaceutical care and health policy. She is project leader of project ‘e-Medication’ on the influence of internet on medicines use and involved in projects on the EU regulatory system for medicinal products and clinical trials. Furthermore, she is working on her PhD in a strategic research project on the utilization of knowledge within public health policy and healthcare supervision.
Abstract:
Patient empowerment is crucial in the successful self-management of people with chronic diseases. We investigated whether discussions about medicine use taking place on online message boards contribute to patient empowerment.From seven Dutch message boards, we analyzed posts related to the conditions ADHD, ALS and diabetes by a deductive thematic analysis method and coded the posts for empowerment processes and the quality of the information exchanged. Patient empowerment processes were identified in posts related to all three disorders. There is some variation in the frequency of these processes, but they show a similar order in the results: Patients used the online message boards to exchange information, share personal experiences and for empathy or support. The type of information shared in these processes could contribute to the patient’s self-efficacy when it comes to medicine use. The exchanged information was either correct or largely harmless. We also observed a tendency whereby participants correct previously posted incorrect information, and refer people to a healthcare professional following a request for medical advice, e.g. concerning the choice of medication or dosage. Our findings show that patient empowerment processes occur in posts related to all three disorders and that the type of information shared can contribute to the patient’s self-efficacy when it comes to medicine use. The tendency to refer people to a healthcare professional shows that patients still reserve an important role for healthcare professionals in the care process, despite the development towards more self-management.
Gunnar O Klein
Örebro University School of Business
Sweden
Title: Smart Glasses – a New Mobile Tool for Health Care and Education
Time : 11:10-11:35
Biography:
Gunnar O Klein has spent 40 years on IT for health and medical research. He was for many years working for Karolinska Institutet, the medical University of Stockholm, Sweden both as a cancer researcher and for the development of health informatics research and education. He is now Professor of eHealth at the Centre for Empirical Research on Information Systems at the Örebro University School of Business. He has made many contributions to the development of security techniques for health and semantic interoperability. He was leading European Standardization of Health Informatics in CEN/TC 251 1997-2006 and was a co-founder of the global standardization in ISO/TC 215. He is now involved in research on patient empowerment in interaction with healthcare using apps and other techniques and new innovative functions for managing elderly patients with multimorbidity. He is a member of the regional eHealth steering group and one day a week he works as a primary care physician.
Abstract:
Smart Glasses, defined as a computerized communicator with a transparent screen and a video camera, wearable as a pair of glasses have started to be tested for a variety of health related applications. Smart glasses is an intersting new technology which already has a number of tested applications in medicine which are reviewed in this presentation. It is important that continued testing is carried out in a variety of clinical settings. The applications in medical education are perhaps the most promising, where this tool allows both the supervision of a medical student and reversely to give virtual the presence to students in demanding clinical situations where experienced clinicans are recording the interaction with the patient while performing.
Placide Poba-Nzaou
University of Quebec in Montreal
Canada
Title: Patterns of clinical information systems sophistication: An empirical taxonomy of European hospitals
Time : 11:35-12:00
Biography:
Placide Poba-Nzaou is an Assistant Professor of Information Systems and Human Resource. His research interests include the adoption and implementation of IT in organizations, the impact of IT in healthcare organizations and open source software. The results of his research has been published in internationals refereed journals such as Journal of Information Technology, Information & Management, Information Systems Frontiers, Information, Systems Management, International Journal of Operations & Production Management, International Journal of Health Informatics; as well as international conferences such as HICSS, AMCIS, ECIS. He has an extensive experience as a consultant in the fields of IT and Organizational Development.
Abstract:
Several empirical evidences revealed that a growing number of healthcare organizations are adopting Clinical Information Systems (CIS) to improve their performance. But the outcomes associated with the use of CIS depend, among other things, on the level of their sophistication. Drawing on data from 1000 European hospitals, we conducted an exploratory study to empirically derived patterns of CIS sophistication, combining hierarchical and non-hierarchical cluster analysis algorithms. Our study reveals four different clusters or patterns. We also investigate the extent to which contextual factors such as hospital size influence the level of CIS sophistication.
Josep Picas
European Association of Healthcare IT Managers
Spain
Title: IT and reengineering processes in Primary Care. We should do it better
Time : 12:00-12:25
Biography:
Dr. Josep M. Picas. M.D., at the University of Barcelona. Diploma at the ESADE Business School of Barcelona. He is the President of the European Association of Healthcare IT Managers. He began his career in 1974 as a Medical Doctor, he was appointed deputy Director of the Hospital de l’Esperança, in Barcelona, in 1979-84. Medical Director of Municipal Institute of Health Care Services from 1985 to 2004 (Public HMO in Barcelona). He has been Director of the Primary Care of Barcelona City, from 2004 to 2007. CIO at the Hospital del Mar in Barcelona in 2008 and CIO at the Hospital de St. Pau in Barcelona, Spain from 2009 to 2012. Now he is beginning a new project with 2 University Hospitals of Barcelona, pharmaceutical industries and technological companies applying ICT and PBM to healthcare processes under the model of shared savings He has worked actively on the development of disease management programs, computerised information health systems. He participates on Boards and Steering Committees at local and international level. He has belonged to the Board of the International Disease Management Alliance, New Jersey (US) and the Medical Records Institute, Boston (US)
Abstract:
Healthcare is now in an interesting crossroad, the socio demographic evolution, the economic sustainability and the most active role of the patients, makes a big pressure on the healthcare workforce and of course on the managers of these servicesIs generally well accepted that it is needed a dramatic change on the services in the way they are provided, at this level, the use of information technologies at the primary care levels is clear that are having an increasing role, but this solutions, alone, do not obtain the expected results The main reason of failing, as it is known in other sectors, is the lack of process reengineering when we introduce IT solutions With this approach, this presentation will explain the experience with 4 primary care centers (Medical Home - team model) in Barcelona (145 physicians, nurses and support professionals attending 95.000 people).The work done with the clinicians has had three basic points: 1. - Processes (lean healthcare), 2. - Innovation (advanced practice with nurses) and 3. - Clinical leadership Next steps will be open to discussion in future strategies on linking processes with hospitals, social services…, and applying knowledge from concepts as population health management and global health
Sandra Milena Agudelo-Londono
Pontificia Universidad Javeriana
Colombia
Title: Why Diagnosis related groups are not welcome in Colombia?
Time : 12:25-12:50
Biography:
Sandra Agudelo is a Health information system Manager and has a Master in Epidemiology from Universidad de Antioquia in Colombia. She is proffesor of Health information systems and Managerial Epidemiology in Pontificia Universidad Javeriana, Bogotá. She has published several papers in reputed journals and has been serving as member of the editorial board of Gerencia y Políticas de Salud Journal in her country.
Abstract:
Diagnosis Related Groups (DRGs) are a electronic patient classification system that allows hospital homogenize the product to compare the performance of specialists care, reduce the variability of medical practice, improve clinical management and make transparent the payment system. DRGs are used in many countries and would be useful for the Colombian Health system. However, attempts to introduce DRGs in Colombia were unsuccessful. Only eight of fifty high complexity hospitals have DRGs, which makes it an innovation. The existing literature is abundant in the use of DRGs, but is scarce on the reasons for accepting or rejecting DRGs in hospitals. The aim of our study was to explore the determinants for non-implementation of DRGs in hospitals in Colombia. We use a qualitative case study approach to analyze the perceptions of the directors of six hospitals with and without DRGs in Bogota. The theory of diffusion of innovation was the theoretical basis of the interview applied. It was found that the directors had similar perceptions of the determinants. Although DRGs are perceived as positive, obstacles to implement it were found in two levels: organizational (threats to physician autonomy, culture of non conflict, poor diagnostic coding and emphasis on processes rather than results) and institutional (imperfect health market, negotiation between insurers and providers based on procedures not on diagnoses and finally lack of public policies pro DRGs). It was concluded that unless there is a public policy that leverages the issue, the possibility of DRGs in Colombia is not in the near future. Los Grupos Relacionados de Diagnóstico (GRD) son un sistema de clasificación de pacientes que permite homogeneizar el producto hospitalario para comparar el desempeño de los especialistas, reducir la variabilidad de la práctica médica, mejorar la gestión clínica y hacer transparente el sistema de pagos. Los GRD se utilizan en muchos países y serían útiles para el Sistema General de Seguridad Social en Salud de Colombia. Sin embargo, los intentos de introducir GRD en Colombia fueron infructuosos. Solo ocho de cincuenta hospitales de alta complejidad tienen GRD, que los convierte una innovación para el país. La teoría de difusión de innovación sugiere que la adopción de una innovación depende de sus atributos: ventaja, compatibilidad, complejidad, capacidad de prueba y observabilidad. La literatura existente, abundante en cuanto al uso de los GRD, es escasa sobre los motivos para aceptar o rechazar GRD en hospitales. El objetivo de nuestro estudio fue explorar los determinantes para la no implementación de los GRD en hospitales en Colombia. Enfoque cualitativo de estudio de casos, para analizar las percepciones de los directores de seis hospitales con y sin GRD en Bogotá. La teoría de difusión de la innovación fue el fundamento teórico de la entrevista aplicada. Se encontró que los directores tuvieron percepciones similares frente a los determinantes. Aunque los GRD se percibieron como positivos, se encontraron obstáculos para implementarlos a nivel organizacional (amenaza a la autonomía del médico, cultura del no conflicto, mala codificación diagnóstica y énfasis en procesos en vez de resultados) e institucional (competencia imperfecta en salud, negociación entre aseguradoras y proveedores basada en procedimientos no en diagnósticos y finalmente, falta de políticas públicas pro GRD). Estos hallazgos son únicos en su tipo en el mundo, debido a la particularidad del sistema de salud colombiano. Se concluyó que a no ser que haya una política pública que apalanque el tema, la posibilidad de GRD en Colombia no se ve en el futuro cercano.