Effect of social trust on health information exchange in social network sites

Background: The purpose of this study is to conduct a systematic literature review of the role of social trust in health information exchange on social network sites (SNSs). In the light of the confusion and panic about health information leading to and during the worldwide lockdown, in an attempt to control the spread and symptoms of coronavirus disease 2019 (COVID-19). Although the sharing of health information on SNS did not start during the COVID-19 lockdown, the concerns about health information interchange were highlighted during the lockdown. Objectives: This study investigates the nature of the association between health information exchange and social trust and how social trust has influenced health information exchange from 2005 to 2021. Method: In line with the purpose of the study, the researcher applied a systematic literature review to review conference articles, accredited journal articles and book chapters. The review process involved a rigorous procedure towards a definition of review protocol, extraction of articles, formulation of selection criteria and the review itself. Results: This study reveals a transactional interplay between the constructs of social trust (benevolence, integrity and competence) and social network site user roles (information seeker, information passer and information giver). Conclusion: In summary, the researcher argues that public health officials would benefit from setting up an SNS that proactively provides health information. The health information exchange experience should be designed in a way that takes into account how social trust can be used to moderate health information exchange in the SNS by different types.

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.

Uso de Python para detecção de fake news sobre a covid-19: desafios e possibilidades / Using Python to detect fake news about covid-19: challenges and possibilities / Usar Python para detectar noticias falsas sobre covid-19: desafíos y posibilidades

Este trabalho tem como objetivo relatar estratégias para coleta de um conjunto de dados em português para treinamento de modelos de Inteligência Artificial com vistas a identificar de forma automática fake news sobre covid-19 disseminadas durante a pandemia, a partir de código Python. Analisamos um método de detecção de fake news baseado em uma Rede Neural Recorrente e de aprendizagem supervisionada. Selecionamos um corpus com 7,2 mil textos coletados em websites e agências de notícias por Monteiro et al. (2018) com cada um previamente catalogado como verdadeiro ou falso como conjunto de dados de treino e validação. O modelo foi usado para detecção de fake news sobre covid-19 em um conjunto de notícias coletadas e classificadas pelos autores deste trabalho. O índice de acerto foi de 70%, ou seja, essa foi a taxa de sucesso da detecção dos itens catalogados.

This work aims to report strategies for collecting a dataset in Portuguese for training Artificial Intelligence models to automatically identify fake news about covid-19 disseminated during the pandemic, using Python code. We analyze a fake news detection method based on a Recurrent Neural Network and supervised learning. We selected a corpus with 7,200 texts collected on websites and news agencies by Monteiro et al. (2018), each one of them previously cataloged as true or false as a training and validation dataset. This model was used to detect fake news about covid-19 in a set of news collected and classified by the authors of this work. The hit rate was 70%.

Este trabajo tiene como objetivo informar estrategias para recopilar un conjunto de datos en portugués para entrenar modelos de Inteligencia Artificial para identificar automáticamente noticias falsas sobre covid-19 difundidas durante la pandemia, utilizando el código Python. Analizamos un método de detección de noticias falsas basado en una Red Neuronal Recurrente y de aprendizaje supervisado. Seleccionamos un corpus de 7.200 textos recogidos en webs y agencias de noticias por Monteiro et al. (2018) con cada uno catalogado previamente como verdadero o falso como un conjunto de datos de entrenamiento y validación. El modelo se utilizó para detectar noticias falsas sobre covid-19 en un conjunto de noticias recopiladas y clasificadas por los autores de este trabajo. La tasa de acierto fue del 70%, es decir, esta fue la tasa de éxito de detección de los artículos catalogados.

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.

The influence of records on medical charts as a factor associated with technical disallowances / La influencia de los registros en la historia clínica como uno de los factores que se asocia al fallo técnico hospitalario / A influência dos registros do prontuário como um dos fatores associados à glosa técnica hospitalar

ABSTRACT Objective: identify the influence of records in medical charts as one of the factors associated with technical disallowances. Method: quantitative, analytical, cross-sectional field study conducted in 2018 in two hospitals. A total of 324 payment statements were analyzed, considering five health plan operators in each hospital. These statements contain the codes of disallowances provided in the TISS [Exchange of Information on Supplementary Health] Table. Results: technical disallowances concerning materials were higher than those concerning medications in hospitals 1 and 2, 90.99% and 84.79%, respectively. The factors associated with technical disallowances were hospital stay — p=0.001 in hospital 1 and p=0.01 in hospital 2 — and type of hospitalization in hospital 2, p=0.000. Hospital 1 amounted to R$2,305.61 (2.28%) of disallowances in nine medical charts. However, all the medical charts contained the records of technical reports, which can be appealed. A different result was found for hospital 2, where 43 medical charts totaled R$31,181.14 (17.82%) of disallowances, R$3,096.13 of which concern missing codes (material and medication); hence, no appeal is possible, resulting in financial loss. Conclusion: the monetary amounts of technical disallowances were higher in both hospitals. There is evidence that the length of hospital stay generates disallowances. Therefore, the records in medical charts influence disallowances, and missing records lead to financial loss. TISS standardizes the reasons for disallowances, favoring justifications to appeal, and facilitates the analysis of records and controls of payments to the services provided.

RESUMEN Objetivo: identificar la influencia de los registros en las historias clínicas como uno de los factores asociados al fallo técnico. Método: estudio cuantitativo analítico, de campo, transversal, en el año 2018, en dos hospitales. Se analizaron 324 extractos de pago, con cinco operadores de cada hospital. En estas declaraciones se describen los códigos del fallo que hacen referencia a la Tabla de Dominio de Intercambio de Información Sanitaria Suplementaria (TISS). Resultados: en los hospitales 1 y 2, el fallo técnico del material fue superior a la de la medicación, siendo del 90,99% y del 84,79%, respectivamente. Los factores asociados al fallo técnico fueron la duración de la estancia; p = 0,001 en el hospital 1 y p = 0,01 en el hospital 2, y el tipo de ingreso en el hospital 2 con p = 0,000. El Hospital 1 presentó R$ 2.305,61 (2,28%) de fallos en nueve historias clínicas. Sin embargo, todos presentaron registros de informe técnico, las cuales pueden ser apeladas. Resultados diferentes en el hospital 2, donde se han encontrado 43 historias clínicas, por un valor de R$ 31.181,14 (17,82%) y, de este valor, R$ 3.096,13 se refieren a los códigos de material y de medicamentos, no teniendo registros en las historias clínicas y no siendo posible apelar, acarreando pérdidas. Conclusión: en los dos hospitales, el valor del fallo técnico del material fue mayor. Hay pruebas de que el tiempo de permanencia puede generar fallos, y en cuanto al registro en la historia clínica, este influye en el fallo y, cuando falta, genera una pérdida financiera. El uso del TISS normaliza los motivos de los fallos, favorece la realización de la justificación del recurso, facilita el análisis de los expedientes y ayuda a controlar el pago del servicio prestado.

RESUMO Objetivo: identificar a influência dos registros no prontuário como um dos fatores associados à glosa técnica. Método: estudo quantitativo analítico, de campo, transversal, realizado no ano de 2018 em dois hospitais. Foram analisados 324 demonstrativos de pagamento, sendo cinco operadoras de cada hospital. Nesses demonstrativos, estão descritos códigos de glosa referentes à Tabela de Domínio de Troca de Informações de Saúde Suplementar (TISS). Resultados: nos hospitais 1 e 2, a glosa técnica de material foi maior que a de medicamento, sendo 90,99% e 84,79%, respectivamente. Os fatores associados à glosa técnica foram o tempo de permanência — p = 0,001 no hospital 1 e p = 0,01 no hospital 2 — e o tipo de internação no hospital 2, com p = 0,000. O hospital 1 apresentou R$ 2.305,61 (2,28%) de glosa em nove prontuários. Contudo, todos apresentaram registros de relatório técnico, que pode ser recursado. O resultado foi diferente do hospital 2, onde foram glosados 43 prontuários, no valor de R$ 31.181,14 (17,82%); desse valor, R$ 3.096,13 são referentes aos códigos de material e de medicamentos, não havendo registros em prontuários e não sendo possível fazer recurso, acarretando perda. Conclusão: nos dois hospitais, o valor da glosa técnica de material foi maior. Há evidência de que o tempo de permanência pode gerar glosa. Quanto ao registro no prontuário, este influencia na glosa e, quando ausente, gera perda financeira. A utilização do TISS padroniza os motivos de glosas, favorece a realização da justificativa do recurso, facilita a análise dos registros e auxilia no controle do pagamento do serviço prestado.

Effect of video-based information on preoperative State trait anxiety inventory scores in adult patients presenting for elective caesarean section: a randomized controlled trial

Background: Preoperative anxiety is a common occurrence in patients presenting for surgery with a reported incidence of up to 80%. Increased preoperative anxiety has been associated with increased morbidity. Provision of information relating to surgery and anesthesia to patients has been proven to have benefit in allaying anxiety. However, the best format of information dissemination remains unknown. Objective: To determine the effect of video information in addition to the pre-anesthetic review on the mean preoperative State anxiety inventory (STAI-S) score in adult patients presenting for elective caesarean section under spinal anesthesia at Aga Khan University Hospital, Nairobi (AKUHN), and to determine the prevalence of preoperative anxiety in the obstetric population presenting for elective caesarean section at AKUHN. Methods: Thirty-seven adult patients booked for elective caesarean section under spinal anesthesia were randomly assigned to one of two groups. In the study arm, a video was shown to the participants in addition to the standard pre-anesthetic review. In the control arm the participants only had a standard pre-anesthetic review. Results: The mean STAI-T score in the sampled population was 45.64 (SD 5.625). The mean baseline STAI-S score was 46.32 (SD 4.911). There was no statistically significant difference in change in STAI score between the video and control arms (p>0.05). Conclusion: On the basis of this study among this population, there was no benefit demonstrated from the use of an information video about spinal anesthesia on anxiety levels in obstetric patients presenting for a first time spinal

¿Cómo registramos en las historias clínicas de nuestros pacientes que hay un niño o adolescente con discapacidad en la familia?: estudio de corte transversal / How do we record in our patients' medical records the presence of a child or adolescent with a disability in the family?: a cross-sectional study

Introducción. Para cuidar a las familias de una persona con discapacidad es necesario correr el foco desde el paciente individual hacia su sistema familiar, tarea difícil de implementar en el ámbito de la atención primaria, y para la que no se cuenta con datos locales respecto de esta problemática. Objetivo. Describir qué proporción de las historias clínicas de las personas adultas que integran una familia en la que hay un niño o adolescente menor de 18 años con discapacidad tiene documentada esta información contextual. Métodos. Fueron revisadas hasta el 31/12/19, 250 historias clínicas electrónicas de adultos familiares de primer grado de una muestra aleatoria de 153 menores de 18 años de edad afiliados al Plan de Salud del Hospital Italiano de Buenos Aires que tenían Certificado Único de Discapacidad. Resultados. Estos 250 adultos habían realizado una mediana de seis consultas con su médico de cabecera. Solamente en 117 (47 %, intervalo de confianza del 95 % 40 a 53) historias clínicas electrónicas estaba documentado que en su familia directa había un menor con discapacidad, y sólo en 18 (7 %) esta información estaba consignada en su lista de problemas. Conclusiones. En más de la mitad de la muestra de adultos estudiada no está documentado en su historia clínica electrónica que en la familia de esa persona hay un menor con discapacidad. Estos hallazgos llaman la atención, por tratarse de un sistema de salud que ofrece atención coordinada a través de la figura de un médico de cabecera. (AU)

Introduction. In order to care for the families of a person with a disability, it is necessary to shift the focus from the individual patient to their family system. This is a difficult task to implement in the primary care field and for which no local data on this issue are available. Objective. To describe the proportion of electronic medical records of adult people in a family with a disabled child or adolescent under 18 years old in which this contextual information is documented. Methods. A total of 250 electronic medical records were reviewed up to 31/12/19 regarding first-degree adult relatives froma random sample of 153 children under the age of 18 affiliated to the Health Maintenance Organization of the HospitalItaliano de Buenos Aires who had a Disability Certificate. Results. These 250 adults had made an average of six consultations with their primary care physician. Only 117 (47 %,95 % confidence interval 40 a 53) electronic medical records documented that their immediate family included a child witha disability, and only 18 (7 %) had this information on their problem list. Conclusions. More than half of the sample of adults studied did not have documented in their electronic medical records that there was a child with a disability in their family. These findings are striking given that this Health Maintenance Organization offers coordinated care through the figure of a primary care physician. (AU)

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.

Electronic Medical Records in the American Health System: challenges and lessons learned / Registros Eletrônicos de Saúde no Sistema de Saúde norte-americano: desafios e lições aprendidas

Abstract Electronic medical records have been touted as a solution to many of the shortcomings of health care systems. The aim of this essay is to review pertinent literature and present examples and recommendations from several decades of experience in the use of medical records in primary health care, in ways that can help primary care doctors to organize their work processes to improve patient care. Considerable problems have been noted to result from a lack of interoperability and standardization of interfaces among these systems, impairing the effective collaboration and information exchange in the care of complex patients. It is extremely important that regional and national health policies be established to assure standardization and interoperability of systems. Lack of interoperability contributes to the fragmentation of the information environment. The electronic medical record (EMR) is a disruptive technology that can revolutionize the way we care for patients. The EMR has been shown to improve quality and reliability in the delivery of healthcare services when appropriately implemented. Careful attention to the impact of the EMR on clinical workflows, in order to take full advantage of the potential of the EMR to improve patient care, is the key lesson from our experience in the deployment and use of these systems.

Resumo Os registros médicos eletrônicos (RME) têm sido apontados como uma solução para muitas das deficiências dos sistemas de saúde. O objetivo deste ensaio é revisar a literatura pertinente e apresentar exemplos e recomendações de várias décadas de experiência no uso de registros médicos na atenção primária à saúde, de maneira a ajudá-los na organização de seus processos de trabalho para melhorar o atendimento ao paciente. Observou-se que problemas consideráveis resultam da falta de interoperabilidade e padronização de interfaces entre esses sistemas, prejudicando a colaboração efetiva e a troca de informações no atendimento a pacientes complexos. É extremamente importante que políticas regionais e nacionais de saúde sejam estabelecidas para garantir a padronização e interoperabilidade dos sistemas. A falta de interoperabilidade contribui para a fragmentação do ambiente de informações. O prontuário eletrônico (RME) é uma tecnologia disruptiva que pode revolucionar a maneira como cuidamos dos pacientes. Foi demonstrado que o RME melhora a qualidade e a confiabilidade na prestação de serviços de saúde quando implementada adequadamente. Uma atenção cuidadosa ao impacto do RME nos fluxos de trabalho clínicos, a fim de aproveitar ao máximo o potencial do RME para melhorar o atendimento ao paciente, é a principal lição de nossa experiência na implantação e uso desses sistemas.

Impacto das ações de alimentação dos sistemas de informação da atenção primária sobre a atenção aos indivíduos e comunidade / The impact of data inputting in the primary health care information systems related to the individuals and community care / Impacto de las acciones de alimentación de los sistemas de información de la atención primaria sobre la atención a los individuos y la comunidad

Objetivo: Avaliar a influência das ações de alimentação dos Sistemas de Informação utilizados na Atenção Primária a Saúde (APS) sobre os cuidados de enfermagem ao indivíduo ou comunidade. Método: Pesquisa quantitativa, com enfermeiros da Atenção Primária. Utilizaram-se os testes ANOVA one-way, Kruskal-Wallis e correlação de Spearman com significância de 5% e confiança de 95%. Resultados: A maioria dos enfermeiros era mulher (94,5%), 34,4 anos de idade, 8,8 anos de formação, sendo 7,6 anos atuando na atenção primária, especialista e concursada. Observou-se associação negativa (p-valor = 0,008) entre tempo destinado às atividades de alimentação dos sistemas e o tempo de atenção aos pacientes. Conclusão: O estudo aponta a influência das ações gerenciais voltadas aos sistemas de informação sobre a atenção prestada aos indivíduos/comunidade

Objective: To evaluate the influence of the feeding actions of the Information Systems used in Primary Health Care (PHC) on nursing care to the individual or community. Methods: Quantitative research with primary care nurses. One-way ANOVA, Kruskal-Wallis and Spearman correlation with significance of 5% and 95% confidence were used. Results: The majority of the nurses were women (94.5%), 34.4 years old, 8.8 years of training, and 7.6 years working in primary care, specialist and bankrupt. A negative association (p-value = 0.008) was observed between time spent feeding the systems and patient care time. Conclusion: The study points out the influence of the managerial actions directed to the information systems on the attention given to the individuals / community

Objetivo: Evaluar la influencia de las acciones de alimentación de los Sistemas de Información utilizados en la Atención Primaria a la Salud (APS) sobre los cuidados de enfermería al individuo o comunidad. Método: Investigación cuantitativa, con enfermeros de la Atención Primaria. Se utilizaron las pruebas ANOVA de una forma, Kruskal-Wallis y correlación de Spearman con significancia del 5% y confianza del 95%. Los resultados: La mayoría de los enfermeros eran mujeres (94,5%), 34,4 años de edad, 8,8 años de formación, siendo 7,6 años actuando en la atención primaria, especialista y concursada. Se observó asociación negativa (p-valor = 0,008) entre tiempo destinado a las actividades de alimentación de los sistemas y el tiempo de atención a los pacientes. Conclusión: El estudio apunta la influencia de las acciones gerenciales dirigidas a los sistemas de información sobre la atención prestada a los individuos / comunidad

Saúde digital: interseções entre a pesquisa científica e sua midiatização / Digital health: intersections between scientific research and its mediatization / Salud digital: intersecciones entre la investigación científica y su mediatización

Este ensaio apresenta a relação entre as divulgações científicas e as jornalísticas sobre saúde digital, utilizando como base metodológica a midiatização e as textualidades midiáticas. Foi possível demonstrar a similaridade entre os produtos e serviços estudados/divulgados. Os temas em voga foram Internet das coisas, aplicativos, dispositivos vestíveis, Inteligência Artificial, Big Data e robótica. Enquanto nos artigos científicos são apontadas vantagens e desvantagens das aplicações tecnológicas, sendo mais críticos, na mídia especializada valorizam-se as vantagens.

This essay presents the relationship between the scientific and the journalistic articles about digital health, using as a methodological basis the mediatization and the mediatic textuality. It was possible to demonstrate the similarity between the products and services studied/disclosed. The hot topics were Internet of Things, apps, wearable devices, Artificial Intelligence, Big Data and robotics. While in the scientific articles are pointed out advantages and disadvantages of technological applications, being more critical, in the specialized media the advantages are more valued.

Este ensayo presenta la relación entre las divulgaciones científicas y las periodísticas sobre salud digital, utilizando como base metodológica la mediatización y la textualidad mediática. Se pudo demostrar la similitud entre los productos y servicios estudiados/divulgados. Los temas en boga fueron Internet de las cosas, aplicaciones, dispositivos usables, Inteligencia Artificial, Big Data y robótica. Mientras que en los artículos científicos se apuntan ventajas y desventajas de las aplicaciones tecnológicas, siendo estas más críticas, en los medios especializados se valoran mucho más las ventajas.

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.

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.

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.

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.

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.

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.