Análisis de las interacciones entre los actores de la Red de Gestión del Conocimiento, Investigación e Innovación en Malaria de Colombia / Analysis of interactions between actors of the Red de Gestión del Conocimiento e Innovación en Malaria de Colombia

Introducción. La malaria, o paludismo, es una enfermedad de gran impacto en la población colombiana, que debe ser abordada desde el punto de vista del trabajo en equipo de instituciones para el intercambio de conocimiento. Objetivo. Analizar las interacciones de la Red de Gestión del Conocimiento, Investigación e Innovación en Malaria de Colombia. Materiales y métodos. Se hizo un análisis de redes sociales que permitió identificar la proximidad entre los actores y el grado de conocimiento entre ellos; se observaron indicadores de densidad, diámetro, distancia media y centralidad de grado. El corpus documental para el estudio estuvo constituido por 193 documentos técnicos publicados entre el 2016 y el 2021, que fueron analizados empleando técnicas de procesamiento de texto mediante el lenguaje de programación R. La categorización de la red se realizó a partir de cinco variables: atención integral a pacientes, diagnóstico, epidemiología y sistemas de análisis de información en salud, política pública, y promoción y prevención. Resultados. El análisis de las interacciones indicó que la red la conformaban 99 actores, de los cuales 97 (98 %), mostraron más interés en la producción de conocimientos en epidemiología y sistemas de análisis de información en salud, seguido de la categoría de atención integral a pacientes con 79 (80 %). El 54 % de los actores llevó a cabo estudios de promoción y prevención, siendo esta la categoría de menor abordaje. Conclusiones. Este estudio contribuye al fortalecimiento de estrategias clave en la divulgación del conocimiento sobre la malaria en Colombia.

Introduction: Malaria is a disease with a high impact on Colombian population, which must be approached from the point of view of teamwork of institutions for knowledge exchange. Objective: To analyze the interactions of the Red de Gestión del Conocimiento, Investigación e Innovación en Malaria de Colombia. Materials and methods: An analysis of social networks was applied that allowed identifying the proximity between actors and the degree of knowledge between them. Indicators of density, diameter, average distance, and degree of centrality were observed. The documentary corpus for the study consisted of 193 technical documents published between 2016 and 2021, which were analyzed using text mining using the R programming language. The network was categorized based on five variables: comprehensive patient care, diagnosis, epidemiology and health information analysis systems, public policy and promotion and prevention. Results: The analysis of interactions indicated that the network was made up by 99 actors. The main interest in knowledge production was on epidemiology and health information analysis systems (98 % of the actors), followed by the integral patient care (80 % of the actors). On the contrary, the least approached category was malaria promotion and prevention practices (54 % of the actors). Conclusions: In general, this study contributes to the strengthening of key strategies in the dissemination of knowledge about malaria in Colombia.

AC-Redes semânticas de hashtags: modelo de estudo métrico de informações em saúde em mídias sociais / CA-Hashtags semantic networks: a metric study model of health information on social media / AC-Redes semánticas de hashtags: un modelo de estudio métrico de información de salud en las redes sociales

As mídias sociais são importantes canais de difusão de informações em saúde. O objetivo deste artigo é apresentar um modelo de estudo métrico de informações para minerar temáticas relacionadas à covid-19 no Facebook, intitulado AC-Redes semânticas de hashtags. O modelo é composto pelos métodos de análise de redes semânticas e de análise de coocorrência. As métricas aplicadas no período de maio de 2020 a janeiro de 2021 foram: as frequências de hashtags, as centralidades de grau e de intermediação e o índice incidência-fidelidade; e o estudo de ilhas. As temáticas identificadas foram: 'Educação na pandemia'; 'Trabalho e pandemia'; 'Ciência, saúde e pandemia'; 'Isolamento social na pandemia'; e 'Política e pandemia'. Por meio desse modelo, foi possível identificar as temáticas mais relevantes sobre a covid-19 para os usuários do Facebook.

Social media are important channels for the dissemination of information on public health. The goal of this paper is to present a model of quantitative analysis of information from the hashtags with respect to covid-19 on Facebook, called CA-Hashtag semantic networks. This model consists of the methods of semantic network analysis and co-occurrence analysis.The metrics used from May 2020 to January 2021 were: hashtag's frequency, degree and betweenness centralities and incidence-fidelity index; and study of islands. The themes identified have been: 'Education in the pandemic'; 'Work and pandemic'; 'Science, health and pandemic'; 'Social isolation in the pandemic'; and 'Politics and pandemic'. Applying the proposed model, it has been possible to identify the most relevant themes about covid-19 for Facebook users.

Las redes sociales son canales importantes para la difusión de información sobre salud pública. El objetivo del artículo es presentar un modelo de análisis cuantitativo de información a partir de los contenidos de hashtags relacionadas con covid-19 en Facebook, llamado de AC-Redes semánticas de hashtags. Este modelo es compuesto por los métodos de análisis de redes semánticas y análisis de co-ocurrencia. Las métricas utilizadas desde mayo de 2020 hasta enero de 2021 han sido: la frecuencia de hashtags, las centralidades de grado e intermediación y el índice incidencia-fidelidad; e el estudio de islas. Los temas identificados han sido: 'Educación en la pandemia'; 'Trabajo y pandemia'; 'Ciencia, salud y pandemia'; 'Aislamiento social en la pandemia'; y 'Política y pandemia'. Con basis en el modelo propuesto, ha sido posible identificar los temas más relevantes sobre covid-19 para los usuarios de Facebook.

Processo de cotutela de crianças de alto risco: avaliação da Rede Mãe Paranaense / Co-tutorship process with high-risk children: an evaluation of the Rede Mãe Paranaense

RESUMO Objetivo compreender como se processa a cotutela entre atenção primária à saúde e ambulatório de referência da Rede Mãe Paranaense, no seguimento de crianças de alto risco. Métodos estudo qualitativo, desenvolvido por meio da compreensão do processo de cotutela entre atenção primária à saúde e ambulatório referência da Rede Cegonha, no seguimento de crianças de alto risco. Participaram do estudo, 28 coordenadores da atenção primária e dois representantes dos ambulatórios de alto risco. A coleta de dados ocorreu por meio de entrevistas, que foram transcritas e submetidas à análise categorial temática conforme os pressupostos de Bardin. Resultados da análise dos dados emergiu a categoria Comunicação entre atenção primária à saúde e ambulatórios: desdobramentos na (des)continuidade do cuidado prestado às crianças de alto risco. Evidenciou-se que o processo de cotutela apresenta fragilidades que comprometem a integralidade da assistência prestada. Conclusão a comunicação fragmentada e a falta de alinhamento e de posicionamento de cotutela entre os serviços no contexto da atenção às crianças e seus familiares geram fragilidades no atendimento. Contribuições para a prática o estudo permitiu identificar fragilidades que podem ser cruciais para intervenções futuras no âmbito da rede de atenção infantil de alto risco.

ABSTRACT Objective to understand how the co-tutorship between primary health care and the referral outpatient clinic from the Mother Network from Paraná (Rede Mãe Paranaense) in the follow up of high-risk children. Methods qualitative study carried out by understanding the process of co-tutorship between primary health care and the referral outpatient clinic of the Stork Network (Rede Cegonha) in the follow up of high-risk children. The study included 28 coordinators of primary health care and two representatives of the high-risk clinic. Data collection was carried out through interviews that were transcribed and underwent thematic category analysis according with Bardin's principles. Results data analysis led to the creation of the category Communication between primary health care and outpatient clinics: outcomes of the (dis)continuity of care to high-risk children. It became clear that the process of co-tutorship has weaknesses that prevent the provision of integral care. Conclusion fragmented communication and lack of alignment between the services, in addition to not acting like co-tutors as they provide care to children and their families lead to shortcomings in the attention provided. Contributions to practice the study allowed for the identification of weaknesses that can be crucial for future interventions in the high risk childcare network.

Handover de enfermagem em clínicas cirúrgicas: a interface entre a comunicação e a segurança do paciente / Nursing shift handover in surgical clinics: the interface between communication and patient safety / Traspaso de turnos de enfermería en clínicas quirúrgicas: la interfaz entre la comunicación y la seguridad del paciente

Objetivo: identificar os fatores que interferem na comunicação entre as equipes de enfermagem durante o handover de troca de turno em clínicas cirúrgicas, e sua interface com a segurança do paciente. Método: estudo quantitativo, observacional, com análise descritiva, realizado de abril a julho de 2019, por meio de um roteiro de observação e um formulário, em nove clínicas cirúrgicas de um hospital universitário. Resultados: observou-se 54 handovers e participaram 123 profissionais de enfermagem. Dentre os fatores analisados, destaca-se, a ausência de instrumento padronizado de handover (85,19%) e presença de ruídos sonoros (77,78%). A maioria dos participantes (86,93%) apontaram a omissão de informações, na transferência de cuidados, como o fator mais prejudicial para assistência. Conclusão: os fatores que interferiram na comunicação durante o handover foram: ruídos sonoros, omissão de informações, ausência de instrumento padronizado e atrasos dos profissionais. Acredita-se que a identificação desses fatores contribua para o desenvolvimento de melhores estratégias.

Objective: to identify factors affecting communication between nursing teams during shift handover on surgical wards, and how it interfaces with patient safety. Method: this quantitative, observational study, with descriptive analysis, was conducted on nine surgical wards of a university hospital from April to July 2019, using an observation script and record form. Results: 54 nursing shift handovers were observed, and 123 nursing personnel participated. Of particular note among the factors analyzed were absence of a standardized handover instrument (85.19%) and the presence of noise (77.78%). Most of the participants (86.93%) pointed to missing information at handover as the factor most prejudicial to care. Conclusion: the factors that interfered with communication during handover were: noise, omission of information, absence of a standardized instrument, and staff lateness. It is believed that identifying these factors will help develop better strategies.

Objetivo: identificar los factores que afectan la comunicación entre los equipos de enfermería durante la transferencia de turno en las salas quirúrgicas y cómo interactúa con la seguridad del paciente. Método: este estudio cuantitativo, observacional, con análisis descriptivo, se realizó en nueve salas quirúrgicas de un hospital universitario de abril a julio de 2019, utilizando un guión de observación y formulario de registro. Resultados: se observaron 54 traspasos de turno de enfermería y participaron 123 personal de enfermería. Entre los factores analizados destacan la ausencia de un instrumento de traspaso estandarizado (85,19%) y la presencia de ruido (77,78%). La mayoría de los participantes (86,93%) señaló la falta de información en la entrega como el factor más perjudicial para la atención. Conclusión: los factores que interfirieron en la comunicación durante el traspaso fueron: ruido, omisión de información, ausencia de instrumento estandarizado y tardanza del personal. Se cree que identificar estos factores ayudará a desarrollar mejores estrategias.

Elective Educational Unit: International Exchange Experience in Undergraduate Medical Training / Unidade Educacional Eletiva: Experiência de Intercâmbio Internacional na Graduação em Medicina

ABSTRACT As part of the integrated curriculum, the Elective Educational Unity (EEU) is a tool to support knowledge construction and student autonomy during undergraduate training. The international exchange for undergraduates therefore aims to explore potentialities and challenges within a pedagogical perspective through the experience and understanding ofdiverse educational institutions and health services, through prolonged contact with other professionals and students. One constructive strategy of an elective internship is in conjunction with student associations. This report intends to contribute to medical education by reflecting on how the international elective internship impacts on medical training, analysing its potentialities and challenges. The reportaddresses the steps in accomplishing the exchange, presenting the activities developed in the experience, highlightingthe observed objectives and results, along with reflections on the experience. It is ascertained that the international exchange stimulates the experience, recognition and understanding of other cultures; it helps students build autonomy and stimulates a critical reflexive view which promotes knowledge construction, raising the student's awareness of his own social responsibility as a health professional. Therefore, the Elective Educational Unit encourages the student to elect the exchange as a curricular activity, it supports him on choosing a study area and international or national institution of interest, with the option to liaise with other organizations, for example the student organization. Unquestionably, personal growth is one of the consequences through learning about diversecultures and making new friendships and partnerships between different countries. However, there are challenges, such as adaptation to another cultural context, affective detachment and the understanding that different places have distinct historical, social, economic contexts from one another. Thus, advances and changes are proposed to improve the Elective Educational Unit, stimulating greater student participation in international experiences during undergraduate training, as well as underlining the importance of the supervisor's role in the elective planning process.

RESUMO No currículo integrado, instituiu-se a Unidade Educacional Eletiva (UEE) como uma ferramenta de construção de conhecimento e incentivo da autonomia dos acadêmicos no processo de formação médica. Nesse sentido, o intercâmbio internacional na graduação busca explorar potencialidades e desafios dentro de uma perspectiva pedagógica, por meio da vivência e compreensão das múltiplas formas de organização de outras instituições de ensino e serviços de saúde, pelo convívio com outros profissionais e estudantes.Uma das estratégias de construção do estágio eletivo pode ser em conjunto com associações estudantis. Este relatopretende contribuir, assim, para a formação em Medicina a partir da reflexão sobre como essa internacionalização do estágio eletivo interfere na formação médica, analisando suas potencialidades e desafios. Aborda os passos para a realização do intercâmbio, apresenta as atividades desenvolvidas nessa vivência, destaca finalidades e resultados observados, comreflexões sobre a vivência. Verifica-se que o intercâmbio internacional estimula a vivência, o reconhecimento e a compreensão das culturas; contribui para o estudante construir sua autonomia e estimula a visão crítico-reflexiva, que impacta a construção de conhecimento, tornando-o ciente de sua responsabilidade social como profissional de saúde. Em vista disso, a UEE tem incentivado o estudante a eleger o intercâmbio como uma atividade curricular, apoiando-o na escolha da área de estudo e instituição nacional ou internacional de seu interesse, podendo articular-se com outras organizações, dentre essas a estudantil. Positivamente tem-se o crescimento pessoal pela compreensão de diferentes culturas, novas amizades e parceria entre diferentes países, mas também há desafios, como a adaptação em outro contexto cultural, o distanciamento afetivo e a compreensão de que diferentes locais têm contextos históricos, sociais e econômicos distintos uns dos outros. Com efeito, pontuam-se avanços e mudanças interessantes para o aprimoramento da UEE, estimulando os estudantes a participarem mais da internacionalização durante a graduação, bem como salientando o papel do orientador no processo do planejamento do eletivo.

Comunicação eletrônica entre profissionais de saúde na assistência ao paciente: revisão integrativa / Electronic communication between health professionals in patient assistance: integrative review / Comunicación electrónica entre profisionales de salud em la asistencia al paciente: revisión integrativa

Objetivo: Analisar a literatura científica a respeito da comunicação por meios eletrônicos entre profissionais de saúde. Método: Revisão integrativa da literatura, realizada nas bases de dados e/ou portais PubMed, Biblioteca Virtual em Saúde e Cochrane, até agosto de 2018, com descritores combinados, que respondem à pergunta norteadora: "Como ocorre a comunicação eletrônica entre os profissionais de saúde na assistência ao paciente? ”. Resultados: Seis artigos foram incluídos, publicados de 2011 a 2016, no idioma Inglês. Os recursos foram smartphone, pager e tablet. Os aplicativos utilizados foram WhatsApp, Medigram e Serviço de Mensagens Curtas (SMS). Agilidade, facilidade de uso e auxílio na tomada de decisão foram as vantagens encontradas no uso desse recurso na comunicação dos profissionais; dentre as desvantagens estão ausência de privacidade e de confidencialidade das informações, interrupções na assistência e inabilidade no uso do recurso tecnológico. Conclusão: O uso de aplicativos para troca de mensagens e comunicação interdisciplinar de fato proporciona agilidade na comunicação, mas a confidencialidade desses dados ainda é uma questão a ser tratada. Assim, cabe ao enfermeiro conduzir a comunicação com os demais profissionais, preservando a privacidade do paciente.

Purpose: To analyze scientific literature regarding the communication via electronic means between health professionals. Method: Integrative revision of the literature carried through databases and/or portals PubMed, Virtual Health Library and Cochrane, until August 2018, with combined describers, who answer to the leading question: "How does the electronic communication between health professionals in patient assistance occur?". Results: Six articles were included, published from 2011 to 2016 in the English language. Features were smartphone, pager and tablet. The applications used were WhatsApp, Medigram and Short Message Service (SMS). Agility, ease of use and support in decision-making were the advantages found in the use of this resource in the communication of professionals; among the disadvantages are lack of privacy and confidentiality of information, interruptions in assistance and inability to use the technological resource. Conclusion: The use of applications for messaging and interdisciplinary communication does indeed provide agility in communication, but the confidentiality of such data is still an issue to be addressed. Thus, it is up to the nurse to conduct communication with the other professionals, preserving the patient's privacy

Objetivo: Analizar la literatura científica acerca de la comunicación por medios electrónicos entre profesionales de salud. Método: Revisión integrativa de la literatura, realizada en las bases de datos y/o portales PubMed, Biblioteca Virtual em Salud y Cochrane, hasta agosto de 2018, con descriptores combinados, que responden a la pregunta orientadora: "¿Cómo ocurre la comunicación electrónica entre los profesionales de salud en la asistencia al paciente?". Resultados: Seis artículos fueron incluidos, publicados de 2011 a 2016, en el idioma Inglés. Los recursos fueron teléfono inteligente,pager y tablet. Las aplicaciones utilizadas fueron Whatsapp, Medigram y Servicio de mensajes cortos (SMS). Agilidad, facilidad de uso y ayuda em la tomada de decisión fueron las ventajas encontradas en el uso de ese recurso en la comunicación de los profesionales; entre las desventajas están la ausencia de privacidad y de confidencialidad de las informaciones, interrupciones em la asistencia e inhabilidad en el uso del recurso tecnológico. Conclusión: El uso de aplicaciones para el intercambio de mensajes y la comunicación interdisciplinaria de hecho proporciona agilidad en la comunicación, per la confidencialidad de estos datos sigue siendo una cuestión a tratar. Así, corresponde al enfermero conducir la comunicación con os demás profesionales, preservando la privacidad del paciente.

Barreiras de comunicação: percepção da equipe de saúde / Communication barriers: perception of a healthcare team

Objective: To apprehend the health team's perception of communication barriers and to identify factors that contribute to or interfere with health team communication. Method: Qualitative research with 12 health and administrative professionals, members of a health team at a large pediatric hospital in Curitiba, PR. The data were collected through a semi-structured and recorded interview. For the analysis of the data the analysis of content proposed by Minayo was used. Results: The professionals had knowledge about the concept of communication, about the meaning of communication barriers and the possible consequences. Communication barriers include lack of communication, interruption of communication before the message reaches the destination, lack of interest of the receiver, overload of work and information, non-adequacy of language and technical problems with the medium used. Conclusion: Good communication is needed to ensure that environmental adversities do not interfere with care, so understanding the elements that permeate the development of effective communication is of paramount importance.

Objetivo: Apreender a percepção da equipe de saúde frente às barreiras de comunicação e identificar fatores que contribuem ou interferem na comunicação da equipe de saúde. Método: Pesquisa qualitativa com 12 profissionais de saúde e administrativos, integrantes de uma equipe de saúde em hospital pediátrico de grande porte de Curitiba, PR. Os dados foram coletados por meio de entrevista semiestruturada e gravada. Para a análise dos dados utilizou-se a análise de conteúdo proposta por Minayo. Resultados: Os profissionais possuíam conhecimento sobre o conceito de comunicação, sobre o significado de barreiras de comunicação e as possíveis consequências. Como barreira de comunicação destacam-se a falta de comunicação, interrupção da comunicação antes que a mensagem chegasse ao destino, falta de interesse do receptor, sobrecarga de trabalho e de informações, não adequação da linguagem e problemas técnicos com o meio de comunicação utilizado. Conclusão: Uma boa comunicação é necessária para garantir que adversidades ambientais não interfiram na assistência, portanto o entendimento dos elementos que permeiam o desenvolvimento de uma comunicação eficaz é de extrema importância.

Effect Analyses of a Health Information Exchange in Ophthalmology: Evidence from a Pilot Program

PURPOSE: To estimate the impact of a health information exchange (HIE) pilot project on ophthalmology department care. METHODS: Study sites included 4 ophthalmic clinics in three regions participating in the HIE pilot project (group A), and 12 clinics with similar distances and numbers of patient referrals as group A but who were not participating in the HIE pilot project (group B). The mean wait time, total medical costs, and ophthalmic examinations of referral patients were analyzed. RESULTS: The mean wait times were 8.4 ± 8.0 days in group A, which included 83 patients, and 11.7 ± 15.4 days in group B, which included 417 patients. The wait time was significantly shorter in group A (p = 0.005). Sensitivity analyses also indicated shorter wait times in group A. In 247 patients in group B who were referred to tertiary referral hospitals automatically through the conventional clinical cooperation center with group A, the wait times were 8.4 ± 8.0 and 7.7 ± 8.8 days, respectively, and the total cost of medical care was 260.6 ± 271.4 and 257.0 ± 251.7 thousand Won, respectively. No differences in these factors were found between the groups (p = 0.503, 0.913, respectively). There were no significant differences in participation in the HIE pilot project regarding ophthalmic examinations conducted within 2 weeks since patient referral (p > 0.050 for all). CONCLUSIONS: The HIE is advantageous because it results in shorter wait times to see an ophthalmologist, due to the automatic referral method based on medical records. However, there are no benefits in reducing total costs of medical care or the number of clinical examinations.

Privacy Enhanced Healthcare Information Sharing System for Home-Based Care Environments / 대한의료정보학회지

OBJECTIVES: Home-based nursing care services have increased over the past decade. However, accountability and privacy issues as well as security concerns become more challenging during care provider visits. Because of the heterogeneous combination of mobile and stationary assistive medical care devices, conventional systems lack architectural consistency, which leads to inherent time delays and inaccuracies in sharing information. The goal of our study is to develop an architecture that meets the competing goals of accountability and privacy and enhances security in distributed home-based care systems. METHODS: We realized this by using a context-aware approach to manage access to remote data. Our architecture uses a public certification service for individuals, the Japanese Public Key Infrastructure and Health Informatics-PKI to identify and validate the attributes of medical personnel. Both PKI mechanisms are provided by using separate smart cards issued by the government. RESULTS: Context-awareness enables users to have appropriate data access in home-based nursing environments. Our architecture ensures that healthcare providers perform the needed home care services by accessing patient data online and recording transactions. CONCLUSIONS: The proposed method aims to enhance healthcare data access and secure information delivery to preserve user's privacy. We implemented a prototype system and confirmed its feasibility by experimental evaluation. Our research can contribute to reducing patient neglect and wrongful treatment, and thus reduce health insurance costs by ensuring correct insurance claims. Our study can provide a baseline towards building distinctive intelligent treatment options to clinicians and serve as a model for home-based nursing care.

Clinical Decision Support Functions and Digitalization of Clinical Documents of Electronic Medical Record Systems / 대한의료정보학회지

OBJECTIVES: The objective of this study was to investigate the clinical decision support (CDS) functions and digitalization of clinical documents of Electronic Medical Record (EMR) systems in Korea. This exploratory study was conducted focusing on current status of EMR systems. METHODS: This study used a nationwide survey on EMR systems conducted from July 25, 2018 to September 30, 2018 in Korea. The unit of analysis was hospitals. Respondents of the survey were mainly medical recorders or staff members in departments of health insurance claims or information technology. This study analyzed data acquired from 132 hospitals that participated in the survey. RESULTS: This study found that approximately 80% of clinical documents were digitalized in both general and small hospitals. The percentages of general and small hospitals with 100% paperless medical charts were 33.7% and 38.2%, respectively. The EMR systems of general hospitals are more likely to have CDS functions of warnings regarding drug dosage, reminders of clinical schedules, and clinical guidelines compared to those of small hospitals; this difference was statistically significant. For the lists of digitalized clinical documents, almost 93% of EMR systems in general hospitals have the inpatient progress note, operation records, and discharge summary notes digitalized. CONCLUSIONS: EMRs are becoming increasingly important. This study found that the functions and digital documentation of EMR systems still have a large gap, which should be improved and made more sophisticated. We hope that the results of this study will contribute to the development of more sophisticated EMR systems.

Mapeamento terminológico no domínio da radiologia obstétrica: estudo estatístico a partir de ontologias / Terminological mapping in the domain of the obstetric radiology: a statistical study based on ontologies / Mapeamiento terminológico en el dominio de la radiología obstétrica: estudio estadístico a partir de ontologías

Este artigo tem como base um estudo em que foram levantados e organizados termos do domínio da radiologia obstétrica e, então, foi identificado se os mesmos estão compreendidos em quatro distintos vocabulários controlados: OntoNeo, RadLex, LOINC e SNOMED. É apresentado o Sistema Integrado Catarinense de Telemedicina e Telessaúde (STT/SC) e o projeto de estruturação de laudos de exames de radiologia obstétrica, bem como o contexto teórico da ciência da informação sobre vocabulários controlados.Foram realizadas uma pesquisa de campo para o levantamento dos termos junto a um especialista da área e uma pesquisa documental para o levantamento estatístico dos termos em vocabulários controlados.Constituiu-se uma hierarquia dos termos levantados e verificou-se a cobertura de cada um dos vocabulários controlados em relação aos termos. O SNOMED é o vocabulário controlado com maior potencial de uso para a indexação de laudos no domínio da radiologia obstétrica.(AU)

This article bases on a study in which terms of the obstetric radiology domain were collected and arranged, and then we identified whether they are comprised in four distinct controlled vocabularies: OntoNeo, RadLex, LOINC and SNOMED. We present the STT/SC ­ Sistema Integrado Catarinense de Telemedicina e Telessaúde (Santa Catarina's integrated system of telemedicine and tele health) and theproject of structuring diagnostic reports of tests in obstetric radiology, as well as the theoretical contextof information science about controlled vocabulary. We carried out a survey of the terms jointly an expertand a documentary research to the statistical survey of the terms from controlled vocabularies. A hierarchy of the terms collected was established and the coverage of each of the controlled vocabularies in relation to the terms was verified. The SNOMED is the controlled vocabulary with greater potential of use for theindexation of diagnostic reports in the field of obstetric radiology.

Este artículo se basa en un estudio en el cual fueron levantados y arreglados términos del dominio de la radiología obstétrica, y entonces fue identificado si los mismos están comprendidos en cuatro distintos vocabularios controlados: el OntoNeo, el RadLex, el LOINC y el SNOMED. Presentamos el STT/SC ­ Sistema Integrado Catarinense de Telemedicina e Telessaúde (sistema integrado catarinense de telemedicina y telesalud) y el proyecto de estructuración de resultados de exámenes de radiología obstétrica, así como el contexto teórico de la ciencia de la información sobre vocabularios controlados. Una investigación de campo fue realizada para el levantamiento de los términos junto a un especialista y una investigación documental para el levantamiento estadístico de los términos en vocabularios controlados. Se ha constituido una jerarquía de los términos levantados y se ha verificado la cobertura de cada uno de los vocabularios controlados en relación a los términos. El SNOMED es el vocabulario controlado con mayor potencial deuso para la indexación de los resultados de exámenes en el dominio de la radiología obstétrica.

Design of a Hospice Referral System for Terminally Ill Cancer Patients Using a Standards-Based Health Information Exchange System / 대한의료정보학회지

OBJECTIVES: The demand for hospice has been increasing among patients with cancer. This study examined the current hospice referral scenario for terminally ill cancer patients and created a data form to collect hospice information and a modified health information exchange (HIE) form for a more efficient referral system for terminally ill cancer patients. METHODS: Surveys were conducted asking detailed information such as medical instruments and patient admission policies of hospices, and interviews were held to examine the current referral flow and any additional requirements. A task force team was organized to analyze the results of the interviews and surveys. RESULTS: Six hospices completed the survey, and 3 physicians, 2 nurses, and 2 hospital staff from a tertiary hospital were interviewed. Seven categories were defined as essential for establishing hospice data. Ten categories and 40 data items were newly suggested for the existing HIE document form. An implementation guide for the Consolidated Clinical Document Architecture developed by Health Level 7 (HL7 CCDA) was also proposed. It is an international standard for interoperability that provides a framework for the exchange, integration, sharing, and retrieval of electronic health information. Based on these changes, a hospice referral scenario for terminally ill cancer patients was designed. CONCLUSIONS: Our findings show potential improvements that can be made to the current hospice referral system for terminally ill cancer patients. To make the referral system useful in practice, governmental efforts and investments are needed.

Public Acceptance of a Health Information Exchange in Korea / 대한의료정보학회지

OBJECTIVES: We assessed the public acceptance of a health information exchange (HIE) and examined factors that influenced the acceptance and associations among constructs of the Technology Acceptance Model (TAM). METHODS: We collected data from a survey of 1,000 individuals in Korea, which was administered through a structured questionnaire. We assessed the validity and reliability of the survey instrument with exploratory factor analysis and Cronbach's alpha coefficients. We computed descriptive statistics to assess the acceptance and performed regression analyses with a structural equation model to estimate the magnitude and significance of influences among constructs of TAM. RESULTS: Eighty-seven percent of the respondents were willing to use the technology, and the average level of agreement with the need for the technology was 4.16 on a 5-point Likert scale. The perception of ease of use of the technology significantly influenced perceptions of usefulness and attitudes about the need for HIE. Perceptions of usefulness influenced attitude and behavioral intention to use HIE, and attitude influenced intention. Age showed a wide range of influences throughout the model, and experience with offline-based information exchange and health status also showed noteworthy influences. CONCLUSIONS: The public acceptance of HIE was high, and influences posited by TAM were mostly confirmed by the study results. The study findings indicated a need for an education and communication strategy tailored by population age, health status, and prior experience with offline-based exchange to gain public buy-in for a successful introduction of the technology.

O registro em prontuário coletivo no trabalho do psicólogo na Estratégia Saúde da Família / The record on collective electronic chart in the context of the psychologist's work in Family Health Strategy / El registro en la historia clínica colectiva en el trabajo del psicólogo en la Estrategia de Salud de la Familia

Este artigo constitui um relato de experiência, o qual aborda e problematiza o registro de informações nos prontuários coletivos em equipes de Saúde da Família pelos profissionais de Psicologia vinculados a um Programa de Residência Multiprofissional. O Conselho Federal de Psicologia destaca que o psicólogo, em serviço multiprofissional, deve fazer uso do prontuário único, registrando apenas as informações necessárias aos objetivos do trabalho. Essa questão é complexa uma vez que envolve aspectos éticos e de sigilo profissional. Entretanto, entende-se que tal temática precisa ser discutida pelos profissionais de Psicologia e no cotidiano das equipes, para qualificar o cuidado em saúde.

This study is an experience report that approaches and problematizes the act of recording information on collective charts in the context of Family Health teams carried out by Psychology professionals of a Multiprofessional Residency Program. The Federal Council of Psychology highlights the psychologist that works in a public service should register the information on the chart that the other professionals have access to, recording only information related to the aim of his task. This is a complex subject, once it involves ethical and professional secrecy aspects. Such aspects must be discussed by Psychology professionals in the context of health teams, so as to improve health care.

Este artículo se constituye en un relato de experiencia, el cual aborda y problematiza el registro de informaciones en las historias clínicas colectivas, en equipos de Salud de la Familia, por los profesionales de Psicología vinculados a un Programa de Residencia Multiprofesional. El Consejo Federal de Psicología destaca que el psicólogo en servicio multiprofesional, debe hacer uso de una historia clínica única, registrando solamente las informaciones necesarias para los objetivos del trabajo. Esta cuestión es compleja, una vez que implica aspectos éticos y de secreto profesional. Sin embargo, se entiende que esta temática debe ser discutida por los profesionales de la Psicología y en el cotidiano de los equipos, para calificar el cuidado de la salud.

Building and effect of vendor cloud platform for stomatological materials / 医疗卫生装备

Objective To complete an information chain to support stomatological materials purchase and providing manage-ment.MethodsThe main problems of the materials management information chain were analyzed.The system construction,technical architecture and function design were designed based on B/S and C/S structure.Results The vendor cloud platform completed the information chain for purchase and distribution of stomatological materials,and provided technical support to hospital consumables management.Conclusion The system normalizes stomatological materials management,guarantees the safety,timeliness and accuracy of materials supply,and thus is worthy applying practically.

Technology and Policy Challenges in the Adoption and Operation of Health Information Exchange Systems / 대한의료정보학회지

OBJECTIVES: This study aimed to identify problems and issues that arise with the implementation of online health information exchange (HIE) systems in a medical environment and to identify solutions to facilitate the successful operation of future HIE systems in primary care clinics and hospitals. METHODS: In this study, the issues that arose during the establishment and operation of an HIE system in a hospital were identified so that they could be addressed to enable the successful establishment and operation of a standard-based HIE system. After the issues were identified, they were reviewed and categorized by a group of experts that included medical information system experts, doctors, medical information standard experts, and HIE researchers. Then, solutions for the identified problems were derived based on the system development, operation, and improvement carried out during this work. RESULTS: Twenty-one issues were identified during the implementation and operation of an online HIE system. These issues were then divided into four categories: system architecture and standards, documents and data items, consent of HIE, and usability. We offer technical and policy recommendations for various stakeholders based on the experiences of operating and improving the online HIE system in the medical field. CONCLUSIONS: The issues and solutions identified in this study regarding the implementation and operate of an online HIE system can provide valuable insight for planners to enable them to successfully design and operate such systems at a national level in the future. In addition, policy support from governments is needed.

Registro Eletrônico em Saúde Interoperável: os desafios do padrão OpenEHR / Electronic Health Record Interoperable: the challenges of OpenEHR's standard / Registro Electrónico de Salud Interoperable: los desafíos del estándar openEHR

Objetivo: Investigar as evidências disponíveis na literatura sobre os desafios do OpenEHR para a definição semântica das informações contidas em um registro eletrônico em saúde. Método: Estudo observacional e longitudinal de revisão integrativa. Utilizaram-se as bases de dados IEEEXplore, LILACS, PubMed, SciELO e The ACM Digital Library. Estabeleceram-se como descritores: Registro Eletrônico em Saúde, Interoperabilidade Semântica, Experiência e Desafios com o OpenEHR. Resultados: Foram selecionados dez artigos. Identificaram-se como desafios: definir corretamente os arquétipos (perspectiva técnica e semântica). Isso exige o estabelecimento de uma comunidade de profissionais de saúde aptos a modelarem arquétipos, mantendo o consenso clínico multiprofissional e o nível de granularidade que necessitam. Conclusão: Mesmo com desafios, ainda há um consenso mundial sobre o uso da modelagem em dois níveis para atingir o nível de interoperabilidade ideal e, neste caso, os arquétipos são considerados a base essencial que garantirá o significado preciso da informação que será interoperada.

Objective: To investigate the evidence available in the literature on the challenges of open EHR (Electronic Health Record) for the electronic health record semantic definition. Method: Observational and longitudinal study of integrative review. We used the databases: IEEExplore, LILACS, PubMed, SciELO and The ACM Digital Library. Were established as descriptors: Electronic Registration Health, Semantic Interoperability, Experience and Challenges with the openEHR. Results: We selected ten articles. Were identified as challenges: correctly define the archetypes (technical and semantic perspective). This requires the establishment of a health professional community capable of making archetypes, keeping the multidisciplinary clinical consensus and the level of granularity they need. Conclusion: Despite challenges, there is still a global consensus on the use of modeling on two levels to achieve the optimal level of interoperability and, in this case, the archetypes are considered the essential foundation that will ensure the precise meaning of information to be exchanged.

Objetivo: Investigar la evidencia disponible en la literatura sobre los desafíos de la openEHR (Historia Clínica Electrónica) para la definición semántica del registro electrónico de la salud. Método: Estudio observacional, longitudinal de revisión integradora. Utilizamos las bases de datos IEEEXplore, LILACS, PubMed, SciELO y la Biblioteca Digital ACM. Se establecieron como descriptores: Registro Electrónico de Salud, interoperabilidad semántica, Experiencia y Desafíos con la openEHR. Resultados: Se seleccionaron diez artículos. Fueron identificados como retos: definir adecuadamente los arquetipos (técnica y perspectiva semántica). Esto requiere el establecimiento de una comunidad profesional de la salud capaz de modelar arquetipos, manteniendo el consenso clínico multidisciplinario y el nivel de granularidad que necesitan. Conclusión: A pesar de los desafíos, aún existe un consenso global sobre el uso de modelos en dos niveles para alcanzar el nivel óptimo de interoperabilidad y, en este caso, los arquetipos son considerados la base fundamental que garantizar el significado preciso de la información que se intercambiar.

Sistema de gestión de información de historia clínica electrónica en terapias alternativas / Information management system for electronic medical records in alternative therapies / Sistema de gestão de informação de história clínica electrônica em terapias alternativas

Las terapias alternativas son cada vez más utilizadas en la atención en salud. Actualmente la mayoría de las entidades de salud que prestan dichos servicios realizan el registro de estas intervenciones terapéuticas de forma manual, lo cual produce inconvenientes como: posible pérdida de información, falta de control y seguimiento del paciente, falta de interacción e interoperabilidad con la historia clínica convencional, e imposibilidad de desarrollar estudios estadísticos con información proveniente de dichos registros. El presente artículo presenta un sistema de gestión de información para una historia clínica electrónica en terapias alternativas, basado en un modelo conceptual, y un modelo de interoperabilidad basado en el estándar Health Level 7 (HL7). Para el diseño del modelo conceptual, además de la revisión bibliográfica, se desarrolló una investigación de tipo mixto, con un diseño observacional descriptivo mediante una muestra a conveniencia, conformada por siete docentes y once expertos en terapias alternativas. Se indagó acerca de las características de los instrumentos y herramientas utilizados por los expertos para la gestión de la información. Una vez finalizada la propuesta del modelo, esta fue validada por los expertos. Para el modelo de interoperabilidad se consideraron los aspectos técnicos y sintácticos al diseñar una arquitectura de servicios para el envío y recepción de mensajes. En cuanto a la interoperabilidad sintáctica, se diseñó una estructura de mensaje según HL7 con información de pacientes.

The use of alternative therapies is on the increase in health care. Most of the health institutions currently rendering such services keep manual records of therapeutic interventions, resulting in inconveniences such as the possible loss of information, lack of patient control and follow-up, lack of interaction and interoperability with conventional medical records, and inability to develop statistical studies based on data from those records. The paper presents an information management system for electronic medical records in alternative therapies based on a conceptual model and an interoperability model based on the Health Level 7 (HL7) standard. For the design of the conceptual model, in addition to the literature review, a mixed research study was conducted with a descriptive observational design using a convenience sample of seven teachers and eleven experts on alternative therapies. Participants were asked about the characteristics of the instruments and tools used by information management experts. A model proposal was developed which was validated by the experts. For the interoperability model account was taken of the technical and syntactic aspects involved in the design of a service architecture for message submission and reception. For syntactic interoperability a message structure was designed based on HL7 and patient information.

As terapias alternativas são cada vez mais utilizadas na atenção em saúde. Actualmente a maioria das entidades de saúde que emprestam ditos serviços realizam o registro destas intervenções terapéuticas de forma manual, o qual produz inconvenientes como: possível perda de informação, falta de controle e acompanhamento do paciente, falta de interacção e interoperabilidade com a história clínica convencional, e impossibilidade de desenvolver estudos estatísticos com informação proveniente de ditos registros. O presente artigo apresenta um sistema de gestão de informação para uma história clínica electrônica em terapias alternativas, baseado num modelo conceitual, e um modelo de interoperabilidade baseado no estándar Health Level 7 (HL7). Para o desenho do modelo conceitual, para além da revisão bibliográfica, desenvolveu-se uma investigação de tipo misto, com um desenho observacional descriptivo mediante uma amostra à conveniência, conformada por sete docentes e onze expertos em terapias alternativas. Indagou-se sobre as características dos instrumentos e ferramentas utilizados pelos expertos para a gestão da informação. Uma vez finda a proposta do modelo, esta foi validada pelos expertos. Para o modelo de interoperabilidade foram considerados os aspectos técnicos e sintáticos ao desenhar uma arquitetura de serviços para o envio e recepção de mensagens. Em relação à interoperabilidade sintática, foi desenhada uma estructura de mensagem segundo HL7 com informação de pacientes.

Adoption of Electronic Health Records: A Roadmap for India / 대한의료정보학회지

OBJECTIVES: The objective of the study was to create a roadmap for the adoption of Electronic Health Record (EHR) in India based an analysis of the strategies of other countries and national scenarios of ICT use in India. METHODS: The strategies for adoption of EHR in other countries were analyzed to find the crucial steps taken. Apart from reports collected from stakeholders in the country, the study relied on the experience of the author in handling several e-health projects. RESULTS: It was found that there are four major areas where the countries considered have made substantial efforts: ICT infrastructure, Policy & regulations, Standards & interoperability, and Research, development & education. A set of crucial activities were identified in each area. Based on the analysis, a roadmap is suggested. It includes the creation of a secure health network; health information exchange; and the use of open-source software, a national health policy, privacy laws, an agency for health IT standards, R&D, human resource development, etc. CONCLUSIONS: Although some steps have been initiated, several new steps need to be taken up for the successful adoption of EHR. It requires a coordinated effort from all the stakeholders.

Convergence of Health Level Seven Version 2 Messages to Semantic Web Technologies for Software-Intensive Systems in Telemedicine Trauma Care / 대한의료정보학회지

OBJECTIVES: To present the technical background and the development of a procedure that enriches the semantics of Health Level Seven version 2 (HL7v2) messages for software-intensive systems in telemedicine trauma care. METHODS: This study followed a multilevel model-driven approach for the development of semantically interoperable health information systems. The Pre-Hospital Trauma Life Support (PHTLS) ABCDE protocol was adopted as the use case. A prototype application embedded the semantics into an HL7v2 message as an eXtensible Markup Language (XML) file, which was validated against an XML schema that defines constraints on a common reference model. This message was exchanged with a second prototype application, developed on the Mirth middleware, which was also used to parse and validate both the original and the hybrid messages. RESULTS: Both versions of the data instance (one pure XML, one embedded in the HL7v2 message) were equally validated and the RDF-based semantics recovered by the receiving side of the prototype from the shared XML schema. CONCLUSIONS: This study demonstrated the semantic enrichment of HL7v2 messages for intensive-software telemedicine systems for trauma care, by validating components of extracts generated in various computing environments. The adoption of the method proposed in this study ensures the compliance of the HL7v2 standard in Semantic Web technologies.