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1.
J Am Pharm Assoc (2003) ; 62(4): 1270-1279.e2, 2022.
Article in English | MEDLINE | ID: covidwho-1693318

ABSTRACT

BACKGROUND: Only 60% of adults nationwide and just 36.8% of adults in Alabama have immunization data recorded in an Immunization Information System (IIS). The objective of this study, which took place before the coronavirus disease 2019 (COVID-19) pandemic, was to evaluate the impact of an IIS training program on pharmacists' IIS enrollment, participation, awareness, knowledge, intention, and attitudes. METHODS: A randomized controlled trial was conducted in 2019 among Alabama pharmacists (N = 41) practicing in independently owned pharmacies and providing vaccination services but whose pharmacy was not enrolled in Alabama's IIS (Immunization Patient Registry with Integrated Technology [ImmPRINT]). Intervention pharmacists were offered a 2-hour IIS training program, including an online continuing pharmacy education article, demonstration videos, implementation guide, and informational flyer. Control pharmacies received the informational flyer only. Pharmacy-level outcomes, including enrollment and participation, were obtained from ImmPRINT administrative records. Pharmacist-level outcomes, including awareness, knowledge, intention, and attitudes, were self-reported using baseline, 1-month, and 3-month surveys. Two-way mixed analysis of variance, chi-square, and independent t tests were used to analyze differences in outcomes between and within groups. RESULTS: Enrollment in ImmPRINT was significantly greater among intervention pharmacists' pharmacies (P = 0.035). In particular, 59.1% of intervention pharmacies compared with 26.3% of control pharmacies were enrolled in ImmPRINT at 3 months. No statistically significant differences were found between groups in terms of participation in ImmPRINT. Intervention pharmacists' awareness of IIS was significantly greater than control pharmacists (P = 0.028) at 1 month (postintervention). Furthermore, the IIS training program significantly improved intervention pharmacists' knowledge (P = 0.030) and attitudes (P = 0.016) toward IIS over 3 months compared with the control group. CONCLUSIONS: This pharmacist-centered training program focused on practical strategies to integrate IIS into pharmacy workflow. Results show that pharmacists' enrollment, awareness, knowledge, and attitudes significantly improved as a result of this training. As pharmacists become more involved in immunization efforts, particularly in response to COVID-19, awareness of and participation in responsible immunization documentation are critical.


Subject(s)
COVID-19 , Community Pharmacy Services , Pharmacies , Adult , COVID-19/prevention & control , Humans , Information Systems , Pharmacists , Vaccination
2.
Drug Alcohol Depend ; 232: 109271, 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1616455

ABSTRACT

BACKGROUND: State- and county-level reports suggest that the COVID-19 pandemic exacerbated the opioid crisis. We examined US national trends of nonfatal opioid overdose in 2020 in comparison to pre-COVID years 2018-2019. METHODS: We used National Emergency Medical Services Information System (NEMSIS) data to conduct a temporal analysis from 2018 to 2020. Opioid-related EMS run was defined using five scenarios of naloxone administration. To determine annual patterns and slope inflection points, we used the Prophet model of the time series analysis. Linear slopes and their 95% confidence intervals (CIs) were calculated for pre-stay-at-home (pre-SaH) and SaH periods in 2020 and compared to the slopes during the same time in 2018-2019. Three cut-points for SaH start were considered: March 19, 24, and 29. RESULTS: We identified 91,065, 144,802, and 242,904 opioid-related EMS runs in 2018-2020, respectively. In 2020, opioid-related runs increased in January-June, with a pronounced acceleration in March, which coincides with the stay-at-home (SaH) orders. In both 2018 and 2019, opioid-related runs increased in January-August without the spring acceleration. In 2020, weekly increases (95% CI) during SaH for all examined cut-points were significantly greater than in pre-SaH: 18.09 (16.03-20.16) vs. 6.44 (3.42-9.47) for March 19, 17.77 (15.57-19.98) vs. 4.85 (2.07-7.64) for March 24, 18.03 (15.68-20.39) vs. 4.97(2.4-7.54) for March 29. No significant difference was found between these periods in 2018-2019. CONCLUSIONS: The acceleration of opioid-related EMS runs during the SaH period of 2020 suggests that EMS data may serve as an early warning system for local health jurisdictions to deploy harm reduction/prevention resources.


Subject(s)
COVID-19 , Drug Overdose , Emergency Medical Services , Acceleration , Analgesics, Opioid/therapeutic use , COVID-19/epidemiology , Drug Overdose/drug therapy , Drug Overdose/epidemiology , Humans , Information Systems , Naloxone/therapeutic use , Narcotic Antagonists/therapeutic use , Pandemics , SARS-CoV-2
3.
Vaccine ; 40(5): 752-756, 2022 01 31.
Article in English | MEDLINE | ID: covidwho-1586268

ABSTRACT

BACKGROUND: The Vaccine Safety Datalink (VSD) uses vaccination data from electronic health records (EHR) at eight integrated health systems to monitor vaccine safety. Accurate capture of data from vaccines administered outside of the health system is critical for vaccine safety research, especially for COVID-19 vaccines, where many are administered in non-traditional settings. However, timely access and inclusion of data from Immunization Information Systems (IIS) into VSD safety assessments is not well understood. METHODS: We surveyed the eight data-contributing VSD sites to assess: 1) status of sending data to IIS; 2) status of receiving data from IIS; and 3) integration of IIS data into the site EHR. Sites reported separately for COVID-19 vaccination to capture any differences in capacity to receive and integrate data on COVID-19 vaccines versus other vaccines. RESULTS: All VSD sites send data to and receive data from their state IIS. All eight sites (100%) routinely integrate IIS data for COVID-19 vaccines into VSD research studies. Six sites (75%) also routinely integrate all other vaccination data; two sites integrate data from IIS following a reconciliation process, which can result in delays to integration into VSD datasets. CONCLUSIONS: COVID-19 vaccines are being administered in a variety of non-traditional settings, where IIS are commonly used as centralized reporting systems. All eight VSD sites receive and integrate COVID-19 vaccine data from IIS, which positions the VSD well for conducting quality assessments of vaccine safety. Efforts to improve the timely receipt of all vaccination data will improve capacity to conduct vaccine safety assessments within the VSD.


Subject(s)
COVID-19 , Vaccines , COVID-19 Vaccines , Humans , Immunization , Information Systems , SARS-CoV-2 , United States , Vaccination/adverse effects , Vaccines/adverse effects
4.
Int J Environ Res Public Health ; 18(23)2021 12 02.
Article in English | MEDLINE | ID: covidwho-1559803

ABSTRACT

Program outcome assessment is a complex process that demands careful planning and resources in order to accurately assess higher-order thinking skills. A well-defined assessment approach provides detailed insights into program weaknesses and leads to continuous improvement. Whereas a poor assessment approach does not reflect the underlying weaknesses and may result in a useless effort. Furthermore, each accreditation body may have a different recommended outcome measurement approach. As a result, academic institutions may make adhoc choices just to satisfy accreditation requirements rather than designing a sustainable measurement approach. On the other hand, the magnitude of huge tasks for satisfying multiple accreditation bodies results in fatigue and mental stress for academic staff. ABET is a well-known international program accreditation body, and NCAAA is a local accreditation body for academic programs in the Kingdom of Saudi Arabia. In this paper, we have documented that how a sustainable outcome measurement mechanism can be designed to satisfy both ABET and NCAAA requirements. The core contribution of this paper is relevant specifically for academic programs in the Kingdom striving to meet both ABET and NCAAA requirements and is also relevant for all education programs to design an appropriate program assessment approach to ensure a sustainable process to foster better learning among students.


Subject(s)
Accreditation , Universities , Computers , Humans , Information Systems , Program Evaluation
5.
Front Public Health ; 9: 753493, 2021.
Article in English | MEDLINE | ID: covidwho-1551555

ABSTRACT

Accurate and current information has been highlighted across the globe as a critical requirement for the COVID-19 pandemic response. To address this need, many interactive dashboards providing a range of different information about COVID-19 have been developed. A similar tool in Australia containing current information about COVID-19 could assist general practitioners and public health responders in their pandemic response efforts. The COVID-19 Real-time Information System for Preparedness and Epidemic Response (CRISPER) has been developed to provide accurate and spatially explicit real-time information for COVID-19 cases, deaths, testing and contact tracing locations in Australia. Developed based on feedback from key users and stakeholders, the system comprises three main components: (1) a data engine; (2) data visualization and interactive mapping tools; and (3) an automated alert system. This system provides integrated data from multiple sources in one platform which optimizes information sharing with public health responders, primary health care practitioners and the general public.


Subject(s)
COVID-19 , Pandemics , Australia/epidemiology , Humans , Information Systems , SARS-CoV-2
6.
Proc Natl Acad Sci U S A ; 118(46)2021 11 16.
Article in English | MEDLINE | ID: covidwho-1514448

ABSTRACT

PRACE (Partnership for Advanced Computing in Europe), an international not-for-profit association that brings together the five largest European supercomputing centers and involves 26 European countries, has allocated more than half a billion core hours to computer simulations to fight the COVID-19 pandemic. Alongside experiments, these simulations are a pillar of research to assess the risks of different scenarios and investigate mitigation strategies. While the world deals with the subsequent waves of the pandemic, we present a reflection on the use of urgent supercomputing for global societal challenges and crisis management.


Subject(s)
COVID-19/epidemiology , Medical Informatics Computing/standards , Europe , Humans , Information Dissemination , Information Systems/standards , Medical Informatics Computing/trends
7.
Stud Health Technol Inform ; 285: 173-178, 2021 Oct 27.
Article in English | MEDLINE | ID: covidwho-1502265

ABSTRACT

COVID-19's rapid spreads has caused a global pandemic. On 19th February 2020, Iran reported its first confirmed cases of infections in Qom City and the number of diagnosed cases and the death toll rose exponentially in March [1-3]. Managing the disease, which is considered a pandemic according to the World Health Organization (WHO) [4], requires definite approaches differing according to various factors in each country, which may also lead to (in)effective dealing with the disease. In addition, using international data and information, and WHO advice, especially in the crisis and therapeutic procedures, is one of the best crisis management strategies [5]. For every plan by governances, the first step is collecting information on epidemic distribution for the purpose of isolating provinces and cities at a national scale. Thus, Ministry of Health and Medical Education of Iran (MOHME) attempted to collect the minimum required data on the infection-affected patients based on medical records and epidemiological factors, such as demographic data (gender, age and national code), exposure history (close contact with the infected, suspect patients or even having traveled) and signs and symptoms (fever, cough, shortness or difficulties in breathing, fatigue, anorexia, hemoptysis, sputum production, dyspnea, Myalgia, Pharyngalgia, nausea, vomiting, Diarrhea, Headache, Abdominal pain, Dizziness, etc.). Therefore, to ensure accuracy and validity, and to speed up data collection in an area, Information Technology (IT) tools were required [6]. In this regard, developing an information system with a simple format and user-friendly interface in the shortest possible time was the aim. This study presents the local information system developed in March 2020, which has been registering hospitalized Covide-19-affected patients in Iranian hospitals up till now. In other words, this paper introduces features and procedures of one of the national systems as a health registry that includes clinical information on admitted Covid-19 patients in Iranian hospitals from admission to discharge or death. This system is supported by MOHME, and along with outpatient Point of Care Information Systems (POCS), feeds the national and international pandemic reports and decisions.


Subject(s)
COVID-19 , Data Collection , Hospitals , Humans , Information Systems , Iran/epidemiology , SARS-CoV-2
8.
BMJ Paediatr Open ; 5(1): e001164, 2021.
Article in English | MEDLINE | ID: covidwho-1476632

ABSTRACT

Introduction: Child malnutrition in all forms is known globally as the leading cause of poor health. Planning and solving this challenge require sources that collect data accurately. Nutrition surveillance systems (NSS), nutrition registry systems (NRS) and nutrition information systems (NIS) collect and analyse data on nutrition status. Unfortunately, these systems only exist in a few countries. The methods that these systems use significantly differ and their effectiveness is also scarcely researched. This scoping literature review aimed to conduct a survey on NSS, NRS and NIS that collect data on children's nutrition at national and international levels, along with their attributes. Methods and analysis: The methods and analyses of this scoping review follow the Arksey and O'Malley's methodology. This scoping literature review will be conducted in five stages based on this method. (1) The main research question and subquestions are identified. (2) Relevant studies are extracted. In this step, we will search electronic databases including PubMed, Scopus and ISI Web of Science. A manual search will also be performed in Google Scholar, grey literature, and the websites of organisations such as WHO, UNICEF, Centers for Disease Control and Prevention, National Health Service, International Food Policy Research Institute, Food and Agriculture Organization, Food and Nutrition Technical Assistance, United Nations World Food Programme, and United Nations System Standing Committee on Nutrition. (3) Extracted studies are separately reviewed by two reviewers based on inclusion and exclusion criteria, and eligible studies are then selected. A third reviewer resolves disagreements. (4) A checklist is developed to extract the features. Data of included systems are separately extracted and entered into a checklist by two reviewers. A third reviewer then resolves any disagreement. (5) Data are summarised and analysed and are presented in tables and figures. Discussion: This scoping literature review provides strong evidence of the status of systems that collect data on the status of child nutrition. This evidence can help select best practices which can be applied to develop future systems. It can also be a positive step towards achieving an integrated system.


Subject(s)
Nutritional Status , State Medicine , Child , Humans , Information Systems , Registries , Research Design
9.
Yearb Med Inform ; 30(1): 134-140, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1392948

ABSTRACT

OBJECTIVE: In this synopsis, we give an overview of recent research and propose a selection of best papers published in 2020 in the field of Clinical Information Systems (CIS). METHOD: As CIS section editors, we annually apply a systematic process to retrieve articles for the International Medical Informatics Association Yearbook of Medical Informatics. For seven years now, we use the same query to find relevant publications in the CIS field. Each year we retrieve more than 2,400 papers which we categorize in a multi-pass review to distill a preselection of 15 candidate papers. External reviewers and yearbook editors then assess the selected candidate papers. Based on the review results, the IMIA Yearbook editorial board chooses up to four best publications for the section at a selection meeting. To get an overview of the content of the retrieved articles, we use text mining and term co-occurrence mapping techniques. RESULTS: We carried out the query in mid-January 2021 and retrieved a deduplicated result set of 2,787 articles from 1,135 different journals. We nominated 15 papers as candidates and finally selected four of them as the best papers in the CIS section. As in the previous years, the content analysis of the articles revealed the broad spectrum of topics covered by CIS research. Thus, this year we could observe a significant impact of COVID-19 on CIS research. CONCLUSIONS: The trends in CIS research, as seen in recent years, continue to be observable. What was very visible was the impact of the Corona Virus Disease 2019 (COVID-19) pandemic, which has affected not only our lives but also CIS.


Subject(s)
COVID-19 , Information Systems , Biomedical Research , Health Information Systems , Humans , Medical Informatics
10.
Yearb Med Inform ; 30(1): 105-125, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1392946

ABSTRACT

OBJECTIVE: The year 2020 was predominated by the coronavirus disease 2019 (COVID-19) pandemic. The objective of this article is to review the areas in which clinical information systems (CIS) can be and have been utilized to support and enhance the response of healthcare systems to pandemics, focusing on COVID-19. METHODS: PubMed/MEDLINE, Google Scholar, the tables of contents of major informatics journals, and the bibliographies of articles were searched for studies pertaining to CIS, pandemics, and COVID-19 through October 2020. The most informative and detailed studies were highlighted, while many others were referenced. RESULTS: CIS were heavily relied upon by health systems and governmental agencies worldwide in response to COVID-19. Technology-based screening tools were developed to assist rapid case identification and appropriate triaging. Clinical care was supported by utilizing the electronic health record (EHR) to onboard frontline providers to new protocols, offer clinical decision support, and improve systems for diagnostic testing. Telehealth became the most rapidly adopted medical trend in recent history and an essential strategy for allowing safe and effective access to medical care. Artificial intelligence and machine learning algorithms were developed to enhance screening, diagnostic imaging, and predictive analytics - though evidence of improved outcomes remains limited. Geographic information systems and big data enabled real-time dashboards vital for epidemic monitoring, hospital preparedness strategies, and health policy decision making. Digital contact tracing systems were implemented to assist a labor-intensive task with the aim of curbing transmission. Large scale data sharing, effective health information exchange, and interoperability of EHRs remain challenges for the informatics community with immense clinical and academic potential. CIS must be used in combination with engaged stakeholders and operational change management in order to meaningfully improve patient outcomes. CONCLUSION: Managing a pandemic requires widespread, timely, and effective distribution of reliable information. In the past year, CIS and informaticists made prominent and influential contributions in the global response to the COVID-19 pandemic.


Subject(s)
COVID-19 , Information Systems , Medical Informatics , Telemedicine , Artificial Intelligence , COVID-19/diagnosis , COVID-19 Testing , Contact Tracing , Decision Support Systems, Clinical , Electronic Health Records , Epidemics , Health Information Exchange , Health Information Interoperability , Humans , Information Dissemination
12.
Am J Hosp Palliat Care ; 39(5): 581-583, 2022 May.
Article in English | MEDLINE | ID: covidwho-1379735

ABSTRACT

The arrival of the COVID-19 pandemic to hospitals in New York City stressed our emergency departments (ED) with high patient volume, stresses on hospital resources and the arrival of numerous high acuity, critically ill patients. Amid this time, we sought to leverage the ED Information Systems (EDIS), to assist in connecting critically ill patients, their families, and providers in the ED with palliative care resources. We discuss 4 innovative, thoughtful solutions to assist ED providers in identifying and addressing the acute and unique palliative care needs of COVID patients.


Subject(s)
COVID-19 , Pandemics , Emergency Service, Hospital , Humans , Information Systems , Palliative Care
13.
IEEE Trans Neural Netw Learn Syst ; 32(8): 3401-3411, 2021 08.
Article in English | MEDLINE | ID: covidwho-1276481

ABSTRACT

The novel 2019 Coronavirus (COVID-19) infection has spread worldwide and is currently a major healthcare challenge around the world. Chest computed tomography (CT) and X-ray images have been well recognized to be two effective techniques for clinical COVID-19 disease diagnoses. Due to faster imaging time and considerably lower cost than CT, detecting COVID-19 in chest X-ray (CXR) images is preferred for efficient diagnosis, assessment, and treatment. However, considering the similarity between COVID-19 and pneumonia, CXR samples with deep features distributed near category boundaries are easily misclassified by the hyperplanes learned from limited training data. Moreover, most existing approaches for COVID-19 detection focus on the accuracy of prediction and overlook uncertainty estimation, which is particularly important when dealing with noisy datasets. To alleviate these concerns, we propose a novel deep network named RCoNet ks for robust COVID-19 detection which employs Deformable Mutual Information Maximization (DeIM), Mixed High-order Moment Feature (MHMF), and Multiexpert Uncertainty-aware Learning (MUL). With DeIM, the mutual information (MI) between input data and the corresponding latent representations can be well estimated and maximized to capture compact and disentangled representational characteristics. Meanwhile, MHMF can fully explore the benefits of using high-order statistics and extract discriminative features of complex distributions in medical imaging. Finally, MUL creates multiple parallel dropout networks for each CXR image to evaluate uncertainty and thus prevent performance degradation caused by the noise in the data. The experimental results show that RCoNet ks achieves the state-of-the-art performance on an open-source COVIDx dataset of 15 134 original CXR images across several metrics. Crucially, our method is shown to be more effective than existing methods with the presence of noise in the data.


Subject(s)
COVID-19/diagnosis , Deep Learning , Uncertainty , Algorithms , COVID-19/diagnostic imaging , Diagnosis, Differential , Expert Systems , Humans , Information Systems , Neural Networks, Computer , Pneumonia/diagnosis , Reproducibility of Results , Thorax/diagnostic imaging , Tomography, X-Ray Computed
14.
Int J Environ Res Public Health ; 18(9)2021 04 27.
Article in English | MEDLINE | ID: covidwho-1231461

ABSTRACT

(1) Background: The aim of this study is to provide a better understanding of the requirements to improve routine health information systems (RHISs) for the management of health systems, including the identification of best practices, opportunities, and challenges in the 53 countries and territories of the WHO European region. (2) Methods: We conducted an overview of systematics reviews and searched the literature in the databases MEDLINE/PubMed, Cochrane, EMBASE, and Web of Science electronic databases. After a meticulous screening, we identified 20 that met the inclusion criteria, and RHIS evaluation results were presented according to the Performance of Routine Information System Management (PRISM) framework. (3) Results: The reviews were published between 2007 and 2020, focusing on the use of different systems or technologies and aimed to analyze interventions on professionals, centers, or patients' outcomes. All reviews examined showed variability in results in accordance with the variability of interventions and target populations. We have found different areas for improvement for RHISs according to the three determinants of the PRISM framework that influence the configuration of RHISs: technical, organizational, or behavioral elements. (4) Conclusions: RHIS interventions in the European region are promising. However, new global and international strategies and the development of tools and mechanisms should be promoted to highly integrate platforms among European countries.


Subject(s)
Health Information Systems , Europe , Humans , Information Management , Information Systems , Systematic Reviews as Topic
17.
Prev Chronic Dis ; 18: E19, 2021 03 04.
Article in English | MEDLINE | ID: covidwho-1154769

ABSTRACT

INTRODUCTION: Communication networks among professionals can be pathways for accelerating the diffusion of innovations if some local health departments (LHDs) drive the spread of knowledge. Such a network could prove valuable during public health emergencies such as the novel coronavirus disease 2019 (COVID-19) pandemic. Our objective was to determine whether LHDs in the United States were tied together in an informal network to share information and advice about innovative community health practices, programs, and policies. METHODS: In January and February 2020, we conducted an online survey of 2,303 senior LHD leaders to ask several questions about their sources of advice. We asked respondents to rank up to 3 other LHDs whose practices informed their work on new public health programs, evidence-based practices, and policies intended to improve community health. We used a social network analysis program to assess answers. RESULTS: A total of 329 LHDs responded. An emergent network appeared to operate nationally among 740 LHDs. Eleven LHDs were repeatedly nominated by peers as sources of advice or examples (ie, opinion leaders), and 24 acted as relational bridges to hold these emergent networks together (ie, boundary spanners). Although 2 LHDs played both roles, most LHDs we surveyed performed neither of these roles. CONCLUSION: Opinion leading and boundary spanning health departments can be accessed to increase the likelihood of affecting the rate of interest in and adoption of innovations. Decision makers involved in disseminating new public health practices, programs, or policies may find our results useful both for emergencies and for practice-as-usual.


Subject(s)
COVID-19 , Evidence-Based Practice/standards , Health Information Systems , Information Dissemination/methods , Information Systems/organization & administration , COVID-19/epidemiology , COVID-19/therapy , Communication , Diffusion of Innovation , Health Information Systems/organization & administration , Health Information Systems/trends , Health Knowledge, Attitudes, Practice , Humans , Knowledge Bases , Quality Improvement , SARS-CoV-2 , United States/epidemiology
18.
Am J Public Health ; 111(5): 867-875, 2021 05.
Article in English | MEDLINE | ID: covidwho-1140586

ABSTRACT

Laboratory diagnostics play an essential role in pandemic preparedness. In January 2020, the first US case of COVID-19 was confirmed in Washington State. At the same time, the Washington State Public Health Laboratory (WA PHL) was in the process of building upon and initiating innovative preparedness activities to strengthen laboratory testing capabilities, operations, and logistics. The response efforts of WA PHL, in conjunction with the Centers for Disease Control and Prevention, to the COVID-19 outbreak in Washington are described herein-from the initial detection of severe acute respiratory syndrome coronavirus 2 through the subsequent 2 months.Factors that contributed to an effective laboratory response are described, including preparing early to establish testing capacity, instituting dynamic workforce solutions, advancing information management systems, refining laboratory operations, and leveraging laboratory partnerships. We also report on the challenges faced, successful steps taken, and lessons learned by WA PHL to respond to COVID-19.The actions taken by WA PHL to mount an effective public health response may be useful for US laboratories as they continue to respond to the COVID-19 pandemic and may help inform current and future laboratory pandemic preparedness activities.


Subject(s)
COVID-19 Testing , COVID-19 , Laboratories , Organizational Objectives , Program Development , Public Health , COVID-19/epidemiology , COVID-19/prevention & control , Centers for Disease Control and Prevention, U.S. , Humans , Information Systems , United States , Washington/epidemiology
19.
Prev Chronic Dis ; 18: E19, 2021 03 04.
Article in English | MEDLINE | ID: covidwho-1117489

ABSTRACT

INTRODUCTION: Communication networks among professionals can be pathways for accelerating the diffusion of innovations if some local health departments (LHDs) drive the spread of knowledge. Such a network could prove valuable during public health emergencies such as the novel coronavirus disease 2019 (COVID-19) pandemic. Our objective was to determine whether LHDs in the United States were tied together in an informal network to share information and advice about innovative community health practices, programs, and policies. METHODS: In January and February 2020, we conducted an online survey of 2,303 senior LHD leaders to ask several questions about their sources of advice. We asked respondents to rank up to 3 other LHDs whose practices informed their work on new public health programs, evidence-based practices, and policies intended to improve community health. We used a social network analysis program to assess answers. RESULTS: A total of 329 LHDs responded. An emergent network appeared to operate nationally among 740 LHDs. Eleven LHDs were repeatedly nominated by peers as sources of advice or examples (ie, opinion leaders), and 24 acted as relational bridges to hold these emergent networks together (ie, boundary spanners). Although 2 LHDs played both roles, most LHDs we surveyed performed neither of these roles. CONCLUSION: Opinion leading and boundary spanning health departments can be accessed to increase the likelihood of affecting the rate of interest in and adoption of innovations. Decision makers involved in disseminating new public health practices, programs, or policies may find our results useful both for emergencies and for practice-as-usual.


Subject(s)
COVID-19 , Evidence-Based Practice/standards , Health Information Systems , Information Dissemination/methods , Information Systems/organization & administration , COVID-19/epidemiology , COVID-19/therapy , Communication , Diffusion of Innovation , Health Information Systems/organization & administration , Health Information Systems/trends , Health Knowledge, Attitudes, Practice , Humans , Knowledge Bases , Quality Improvement , SARS-CoV-2 , United States/epidemiology
20.
Epidemiol Prev ; 44(5-6 Suppl 2): 95-103, 2020.
Article in English | MEDLINE | ID: covidwho-1068128

ABSTRACT

OBJECTIVES: to describe the epidemic trends of COVID-19 over time and by area in the territory covered by Milan's Agency for Health Protection (ATS-MI) from February to May 2020. DESIGN: descriptive study of COVID-19 cases. SETTING AND PARTICIPANTS: a new information system was developed to record COVID-19 cases with positive nasopharyngeal swab. Patients resident in the area covered by ATS-MI with symptom onset between February and May 2020 were selected. Different epidemic periods were considered based on the timeline of the various regional and national containment measures. MAIN OUTCOME MEASURES: case fatality ratios, incidence rates, and reproduction number by epidemic period and sub-area of ATS-MI. RESULTS: a total of 27,017 swab-positive COVID-19 cases were included. Mean age was 65 years and males were 45%. Incidence in the ATS-MI area was 776 per 100,000 population. The number of deaths was 4,660, the crude case fatality ratio was 17.3%, higher in males (21.2%) than in females (14.0%). The estimated reproduction number registered its peak (3.0) in the early stages of the epidemic and subsequently decreased. Territorial differences were observed in the epidemic spread, with a higher incidence in the Lodi area. CONCLUSIONS: estimated incidence and case fatality ratios were higher than national estimates for Italy. Each ATS-MI area had different epidemic spread patterns.


Subject(s)
COVID-19/epidemiology , Pandemics , SARS-CoV-2 , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Basic Reproduction Number , COVID-19/diagnosis , COVID-19/mortality , COVID-19/prevention & control , COVID-19 Nucleic Acid Testing , Catchment Area, Health , Child , Comorbidity , Female , Geography, Medical , Government Agencies , Humans , Incidence , Information Systems , Italy/epidemiology , Male , Middle Aged , Pandemics/prevention & control , Population Surveillance , Sex Distribution , Urban Health , Young Adult
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