Fully connecting the Observational Health Data Science and Informatics (OHDSI) initiative with the world of linked open data

The usage of controlled biomedical vocabularies is the cornerstone that enables seamless interoperability when using a common data model across multiple data sites. The Observational Health Data Science and Informatics (OHDSI) initiative combines over 100 controlled vocabularies into its own. However, the OHDSI vocabulary is limited in the sense that it combines multiple terminologies and does not provide a direct way to link them outside of their own self-contained scope. This issue makes the tasks of enriching feature sets by using external resources extremely difficult. In order to address these shortcomings, we have created a linked data version of the OHDSI vocabulary, connecting it with already established linked resources like bioportal, bio2rdf, etc. with the ultimate purpose of enabling the interoperability of resources previously foreign to the OHDSI universe.

Status and development of clinical informatics in Nigeria's health care sector

This paper examines the status and development of clinical informatics in the Nigerian health care sector, highlighting the efforts to promote access to and the use of clinical informatics in Nigeria's health care sector. In a recent survey of major international research databases such as Scopus, it was observed that there is a gap in knowledge on clinical informatics in the country healthcare facilities in Nigeria due to a paucity of literature on clinical informatics. Through a literature review, the paper provides a conceptual background of clinical informatics, discusses the status of clinical informatics in Nigeria, and highlights ICT access and use in the healthcare sectors. It also examines the challenges and opportunities of clinical informatics in Nigeria. The last part of the paper discusses the implications of the reviewed literature through a PEST analysis. The paper provides invaluable information on clinical informatics in Nigeria that can be used to inform and support further studies in this growing field. The paper is a contribution to discussions and debates on the development of social informatics. Keywords: Social informatics, clinical informatics.

Machine Learning to Improve the Effectiveness of ANRS in Predicting HIV Drug Resistance / 대한의료정보학회지

OBJECTIVES: Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) is one of the major burdens of disease in developing countries, and the standard-of-care treatment includes prescribing antiretroviral drugs. However, antiretroviral drug resistance is inevitable due to selective pressure associated with the high mutation rate of HIV. Determining antiretroviral resistance can be done by phenotypic laboratory tests or by computer-based interpretation algorithms. Computer-based algorithms have been shown to have many advantages over laboratory tests. The ANRS (Agence Nationale de Recherches sur le SIDA) is regarded as a gold standard in interpreting HIV drug resistance using mutations in genomes. The aim of this study was to improve the prediction of the ANRS gold standard in predicting HIV drug resistance. METHODS: A genome sequence and HIV drug resistance measures were obtained from the Stanford HIV database (http://hivdb.stanford.edu/). Feature selection was used to determine the most important mutations associated with resistance prediction. These mutations were added to the ANRS rules, and the difference in the prediction ability was measured. RESULTS: This study uncovered important mutations that were not associated with the original ANRS rules. On average, the ANRS algorithm was improved by 79% ± 6.6%. The positive predictive value improved by 28%, and the negative predicative value improved by 10%. CONCLUSIONS: The study shows that there is a significant improvement in the prediction ability of ANRS gold standard.

Measure of Clinical Information Technology Adoption / 대한의료정보학회지

OBJECTIVES: The objective of this study was to create a new measure for clinical information technology (IT) adoption as a proxy variable of clinical IT use. METHODS: Healthcare Information and Management Systems Society (HIMSS) data for 2004 were used. The 18 clinical IT applications were analyzed across 3,637 acute care hospitals in the United States. After factor analysis was conducted, the clinical IT adoption score was created and evaluated. RESULTS: Basic clinical IT systems, such as laboratory, order communication/results, pharmacy, radiology, and surgery information systems had different adoption patterns from advanced IT systems, such as cardiology, radio picture archiving, and communication, as well as computerized practitioner order-entry. This clinical IT score varied across hospital characteristics. CONCLUSIONS: Different IT applications have different adoption patterns. In creating a measure of IT use among various IT components in hospitals, the characteristics of each type of system should be reflected. Aggregated IT adoption should be used to explain technology acquisition and utilization in hospitals.

Health Insurance Claim Review Using Information Technologies / 대한의료정보학회지

OBJECTIVES: The objective of this paper is to describe the Health Insurance Review and Assessment Service (HIRA)'s payment request (PARE) system that plays the role of the gateway for all health insurance claims submitted to HIRA, and the claim review support (CRS) system that supports the work of claim review experts in South Korea. METHODS: This study describes the two systems' information technology (IT) infrastructures, their roles, and quantitative analysis of their work performance. It also reports the impact of these systems on claims processing by analyzing the health insurance claim data submitted to HIRA from April 1 to June 30, 2011. RESULTS: The PARE system returned to healthcare providers 2.7% of all inpatient claims (97,930) and 0.1% of all outpatient claims (317,007) as un-reviewable claims. The return rate was the highest for the hospital group as 0.49% and the lowest rate was found in clinic group. The CRS system's detection rate of the claims with multiple errors in inpatient and outpatient areas was 23.1% and 2.9%, respectively. The highest rate of error detection occurred at guideline check-up stages in both inpatient and outpatient groups. CONCLUSIONS: The study found that HIRA's two IT systems had a critical role in reducing heavy administrative workloads through automatic data processing. Although the return rate of the problematic claims to providers and the error detection rate by two systems was low, the actual count of the returned claims was large. The role of IT will become increasingly important in reducing the workload of health insurance claims review.

The Influence of Job Category and Position on the Information Deficiency: The Case of Korean General Hospital Personnel / 대한의료정보학회지

OBJECTIVE: To investigate whether Korean general hospital personnel get the information required to do their job successfully from hospital information systems or not. METHODS: Survey general hospital personnel who use hospital information systems by mail. Each respondent is requested to evaluate both the extent of information required to do their job successfully and the extent of information that he/she gets from the hospital information systems which he/she is using. The information deficiency is operationally defined to be the difference between the extent of information required and the extent of information supplied. RESULTS: It is revealed that both the specialty and the position of general hospital personnel strongly influence their information deficiency. CONCLUSION: The functions of hospital information systems to support(middle) managers in making managerial decisions and strategic plans should be strengthened. More extensive medical examination and treatment information should be supplied in the form customized to meet diverse needs of doctors, nurses, and dieticians. Special measures to fulfill pharmacists' unsatisfied information needs are urgent too.